Projects per year
Objective: To quantify and describe the nature of deprescribing in a UK teaching hospital.
Method: Prescribing and discontinuation data for admission medication from a hospital’s electronic prescribing system were extracted over 4 weeks. The rationale for discontinuation of a random sample of 200 was determined using medical records. This informed categorisation of deprescribing activity by clinicians into ‘proactive’ or ‘reactive’. Data were extrapolated to estimate the proportion of admission medications deprescribed and the proportion which were reactive and proactive.
Results: From 24,552 admission medicines, 977 discontinuations were recorded. Of the 200 discontinuations sampled for review, only 44 (22.0%) were confirmed deprescribing activities; categorised into 7 (15.9%) proactive and 37 (84.1%) reactive. Extrapolation yielded 0.6% (95% CI 0.5–0.7%) of all admission medications deprescribed.
Conclusion: Limited deprescribing activity, dominated by reactive behaviour was identified, suggesting prescribers require a clinical trigger to prompt deprescribing. There may be scope for increasing proactive deprescribing in hospital, however the extent to which this is feasible is unknown.
- Inappropriate medication
- Medication review
- Medicines optimisation
- United Kingdom
- Norwich Medical School - Associate Professor
- Population Health - Member
- Epidemiology and Public Health - Member
- Health Services and Primary Care - Member
- Norwich Clinical Trials Unit - Member
Person: Research Group Member, Research Centre Member, Academic, Teaching & Research