New tool helps seniors reduce unnecessary medications
91社区 researchers have developed and are licensing a digital tool to help safely reduce patients鈥� use of medications that may be unnecessary or even harmful to them.
When clinicians review a patient鈥檚 file, flags potentially inappropriate medications. In a , the software helped deprescribe such medications in 36 per cent of long-term care residents, nearly triple as many as when reviews were done without the tool.
鈥淪ometimes we blame aging for memory loss or mobility issues when the real culprit is the medications,鈥� said lead author Dr. Emily McDonald, Associate Professor in 91社区鈥檚 Department of Medicine, Scientist at the Research Institute of the 91社区 Health Centre (The Institute) and attending physician at the 91社区 Health Centre. 鈥淚鈥檝e seen patients go from barely responsive to having conversations again after stopping a sedating medication.鈥�
Nearly two thirds of Canadian seniors take five or more medications a day, and the number is significantly higher in long-term care, she added.
How the tool fits into routine care
Medications are typically reviewed every three months in long-term care homes, but the scholars say there鈥檚 no standard approach to deprescribing.
MedSafer works as a checklist for clinicians. It scans a resident鈥檚 medication list alongside their health conditions, flags drugs that may no longer be appropriate and provides guidance on how to stop some medications or for safer alternatives.
The software was co-developed by McDonald and Dr. Todd Lee, Associate Professor in 91社区鈥檚 Department of Medicine and Scientist at The Institute . The trial involved 725 residents in five long-term care homes in New Brunswick who were taking an average of 10 medications each.
The problem with 鈥榩rescribing cascades鈥�
Medications often accumulate over time and are sometimes prescribed to counteract the side effects of other drugs, a pattern known as a 鈥減rescribing cascade.鈥�
鈥淪ome medications can increase the risk of falls, confusion and hospitalizations,鈥� said Lee. 鈥淭he more you take, the more side effects and interactions you can have.鈥�
The researchers鈥� goal is to see MedSafer integrated into primary care, so that overmedication can be addressed before patients enter long-term care.
鈥淭his should be the new standard of care for older adults,鈥� McDonald said. 鈥淣o one should be on a medication that鈥檚 doing more harm than good.鈥�
About the study
鈥溾�� by Emily McDonald and Todd Lee et al. was published in JAMA Network Open.
The research was funded by the Healthy Seniors Pilot Project, a joint initiative of the Public Health Agency of Canada and the Government of New Brunswick.
McDonald and Lee are co-founders of MedSafer Corp., which licenses the software used in the study.
