World Journal of
Pharmaceutical and Life Sciences

PROTOCOL FOR A MULTICENTRE, LONGITUDINAL, SINGLE ARM STUDY EVALUATING AN ALGORITHM FOR DEPRESCRIBING STATINS AND PROTON PUMP INHIBITORS IN NURSING HOME RESIDENTS

Anne G. R. Visser*, Jos M. G. A. Schols, Rob Janknegt, Mathieu A. L. M. Prevoo and Bjorn Winkens

ABSTRACT

Introduction: A range of adverse events, including drug interactions, unplanned hospitalisation and increased all-cause mortality, may occur in frail old people due to polypharmacy. Deprescribing using an evidence-based patient-centred implicit deprescribing algorithm might reduce unnecessary polypharmacy. However, the effectiveness of such an implicit deprescribing algorithm to reduce potentially inappropriate medication has not been proven so far. This article describes the protocol of a study, aiming to determine the effect and feasibility of an implicit deprescribing algorithm to cease potentially inappropriate medication (statins and PPIs) for nursing home residents. Method: The study is a multicentre, longitudinal, single arm study. The aim is to include 125 nursing home residents using a statin and/or Proton pump inhibitor. People in a hospice, geriatric rehabilitation or short-stay unit will be excluded. All participants will receive the deprescribing intervention from their nursing home physician. The primary outcome will be the percentage of patients whose medication has been successfully deprescribed three months (T1) after the intervention. Secondary outcomes include sustainable deprescribing six months (T2) after the intervention, and all possible adverse events after deprescribing. Another secondary outcome measure is related to the feasibility of performing the intervention for physicians and involves the answer on the question “Is deprescribing”. Ethics and dissemination: Ethical approval was obtained from the Zuyderland Human Research Ethics Committee. This study will enable an improved understanding of the feasibitity of deprescribing statins and PPIs in nursing home residents by using an implicit deprescribing algorithm. Trial registration number: NCT04204590

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