D-PRESCRIBE trial – harnessing the power of the physician, pharmacist and patient triad

Reduction of inappropriate prescriptions in seniors requires awareness of harm on the part of patients, physicians and pharmacists. The D-PRESCRIBE – Developing Pharmacist-led Research to Educate and Sensitize Community Residents to the Inappropriate prescription Burden in the Elderly –  trial was the sequel to the EMPOWER trial.

This trial tested the beneficial effect of having pharmacists assist both patients and prescribers to reduce inappropriate prescriptions. In addition to providing patients with education, pharmacists used evidence-based pharmaceutical opinions to communicate with prescribers about the harms of four drug classes – sedative hypnotics, oral sulfonylurea drugs, non-steroidal anti-inflammatory drugs (NSAIDs) and 1st generation antihistamines. At 6 months, 43% of participants in the intervention group no longer filled prescriptions for inappropriate medication compared with 12% in the control group (risk difference, 31% [95% CI, 23% to 38%]). In conclusion, among older adults in Quebec, a pharmacist-led educational intervention compared with usual care resulted in greater discontinuation of prescriptions for inappropriate medications.

Lead: Dr. Cara Tannenbaum

Co-investigators: Philippe Martin, Dr. Sara Ahmed, Dr. Andrea Benedetti, Dr. Robyn Tamblyn, Nancy Zhang, Dr. Justin Turner, Université de Montréal

Contact: [email protected]

Funder (2014-2018): Canadian Institutes of Health Research