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
Funder (2014-2018): Canadian Institutes of Health Research
- Martin P, Tamblyn R, Benedetti A, Ahmed S, Tannenbaum C. Effect of a Pharmacist-Led Educational Intervention on Inappropriate Medication Prescriptions in Older Adults: The D-PRESCRIBE Randomized Clinical Trial. JAMA. 2018 Nov 13;320(18):1889-1898.
- Martin P, Tamblyn R, Ahmed S, Benedetti A, Tannenbaum C. A consumer-targeted, pharmacist-led, educational intervention to reduce inappropriate medication use in community older adults (D-PRESCRIBE trial): study protocol for a cluster randomized controlled trial. Trials. 2015 Jun 10; 16:266.
- Martin P, Tannenbaum C. A prototype for evidence-based pharmaceutical opinions to promote physician-pharmacist communication around deprescribing. Can Pharm J (Ott). 2018 Feb 8;151(2):133-141.
- Zhang YZ, Turner JP, Martin P, Tannenbaum C. Does a Consumer-Targeted Deprescribing Intervention Compromise Patient-Healthcare Provider Trust? Pharmacy (Basel). 2018 Apr 16;6(2).