[Canada] Electronic decision support for deprescribing in older adults living in long-term care-A stepped-wedge cluster randomized trial

[Canada] Electronic decision support for deprescribing in older adults living in long-term care-A stepped-wedge cluster randomized trial
JAMA Network Open; by Emily G. McDonald, Justine L. Estey, Cody Davenport, Émilie Bortolussi-Courval, Jeffrey Gaudet, Pierre Philippe Wilson Registe, Todd C. Lee, Carole Goodine; 5/25
Potentially inappropriate prescribing (PIP) occurs when medications that carry a higher risk of harm than benefit are prescribed. It occurs more often among older adults in the setting of polypharmacy (taking multiple medications) and is costly and harmful. PIP and potentially inappropriate medications (PIMs) contribute to excess adverse drug events, such as falls, fractures, cognitive decline, hospitalization, and death [and] the problem is more pronounced for older adults living in nursing homes (long-term care [LTC] homes). Depending on the screening criteria used, in some studies, the prevalence ranges from 67.8% to 87.7% of nursing home residents. Electronically generated, individualized reports that contained prioritized opportunities for deprescribing in older adults were paired with preexisting quarterly medication reviews [and] this study found that electronic decision support paired with the usual workflow could render the deprescribing process scalable and effective.