A randomised controlled trial of deprescribing to optimise health outcomes for frail older people
Older people living in residential aged care facilities (RACFs) often take many medications. Some tablets cause serious side-effects in older people and many commonly-used drugs increase the risk of confusion, nausea, constipation, dizziness and falls. The benefits of many medications in older people are uncertain, as most drug trials do not include people aged over 65 years or people with more than one medical condition. In previous studies, it has been found that a lot of older people in RACFs continue to take medications that may no longer benefit them, or where the benefits are outweighed by the risk of side effects. Many doctors think frail older people would benefit from taking fewer drugs, but not many studies have investigated the effect of reducing medications (‘deprescribing’).
What is the aim of the study?
The primary aim is to investigate whether reducing multiple medications (deprescribing) is safe among older people living in residential aged care facilities (RACFs). The secondary aims are to determine whether medication reduction improves physical health, cognitive function, and quality of life.
Who can be in this study?
We are currently recruiting a total of 954 participants from Residential Aged Care Facilities (RACFs) in WA and NSW.
To be eligible for the study, a participant has to be:
- A permanent resident in a participating Residential Aged Care Facility
- 65yrs or older
- Taking one or more prescription medications
- Not palliative or in the terminal phase of illness
- Able to understand English.
In addition, the RACF manager, the resident’s GP and family/next-of-kin/person responsible will have to provide written agreement for a resident to be involved.
Each participant will be enrolled in the study for 12 months. His/her GP will continue to be responsible for the clinical care of the participant.
We will collect data on the following outcomes:
- Quality of life
- Anticholinergic and sedative drug exposure
- Number of potentially inappropriate medicines
- Number of regular and PRN prescription medicines
- Hospital admissions
- Independence in activities of daily living
- Cognitive function
This study is a collaboration between The University of Western Australia (UWA) and The University of Sydney. It has been approved by the Human Research and Ethics Committee of UWA and the Sydney Local Health District Human Research Ethics Committee of Concord Repatriation General Hospital (CRGH).
It is funded by Australia Project Grant GNT1045662 of the National Health and Medical Research Council (NHMRC).
For further details or information, please contact the Opti-Med Study (WA) Study Co-ordinator Ms Jenny Tasker on (08) 9224 2746 or by emailing firstname.lastname@example.org