Document Type

Report

Publication Date

Spring 2020

Date of Final Presentation

3-13-2020

Committee Chair

Sara Ahten

Committee Member

Ron Ordona

Abstract/ Executive Summary

Problem Description: Polypharmacy in the frail elderly can lead to suboptimal management of medical issues. Primary Care Providers (PCPs) often lack knowledge of best practices regarding deprescribing and lack a systematic process for assessing mediation appropriateness. A quality improvement project was developed and executed at Housecall Providers, a home-based primary care practice in Portland, Oregon to facilitate the incorporation of deprescribing into daily practice.

Interventions: Following a literature review, a curriculum was developed and utilized during an educational intervention for PCPs regarding deprescribing best practices. A system for introducing new PCPs to evidence-based deprescribing for the frail elderly. This information was translated into materials that are now included in the PCP Handbook. A system for including medication plans in the medical record was developed.

Results: The project showed positive impacts on PCP knowledge and confidence regarding the deprescribing process. Results also demonstrated a strong commitment to practice change as a result of interventions.

Interpretation: Polypharmacy and deprescribing educational efforts should be promoted in primary care to help PCPs gain greater understanding regarding deprescribing best practices and to help PCPs commit to needed deprescribing among their patient panels in order to improve patient outcomes.

Conclusion: Future efforts to help promote safe, effective deprescribing should be a priority for primary care practices. More research is needed on safe and effective deprescribing and policy should follow the evidence as it emerges.

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