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We evaluated deprescribing practices of potentially inappropriate medications (PIMs) on an Internal Medicine ward in Kingston, Ontario.
A retrospective chart review was conducted on patients who were 65 years or older, on 5 or more medications, and hospitalized between November 1, 2017 – December 15, 2017. Medications listed in the 2015 Beer’s Criteria and opioids without a cancer diagnosis were marked as PIMs. Discharge records were used to identify PIMs that were deprescribed.
This study included 157 patients (56.1% female). In total, 234 of 1482 (15.8%) of all medications across all patients were identified as PIMs, and 15.4% of these were deprescribed. The top deprescribed medications were antihypertensives and opioids. Nearly half of the documented deprescribing occurred because of an adverse event.
Less than 20% of PIMs are being discontinued or down-titrated in hospital. This appears to be largely reactionary and driven primarily by adverse events.