Deprescribing in primary care in Portugal (DePil17-20): a three-phase observational and experimental study protocol

• Published in: BMJ open 2018-07, Vol.8 (7), p.e019542-e019542
• Main Authors: Simões, Pedro Augusto, Santiago, Luiz Miguel, Simões, José Augusto
• Format: Article
• Language: English
• Subjects: Clinical decision making; Decision making; Mortality; Older people; Patient-Centred Medicine; Polypharmacy; Systematic review
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-019542

IntroductionPolypharmacy is commonly defined as the simultaneous taking of five or more drugs. Deprescribing is the process of tapering or stopping medications with the aim of improving patient outcomes and optimising current therapy, and there are several tools aiming at identifying potentially inappropriate medications, especially in the elderly. The direct involvement of patients and their caregivers in the choice and administration of drugs has long been known to be very important, but it is not usually applied. The aim of this study is to assess the knowledge of older adults about deprescription, the effect on willingness to have regular medications deprescribed and its quality-of-life outcome.Methods and analysisThis study protocol comprises three phases. The first two phases will be nationwide and aim to evaluate the prevalence and patterns of polypharmacy and assess the barriers and facilitators of deprescribing perceived by older adults, as well as their willingness to have regular medications deprescribed and to self-medicate. The third and last phase will be a non-pharmacological randomised clinical study to measure older patients’ acceptance to have regular medications deprescribed and related quality of life.Ethics and disseminationThe study will be conducted in accordance with the principles expressed in the Declaration of Helsinki. It has been approved by the Ethics Committee of the University of Beira Interior and Portuguese National Data Protection Commission. Study results will be published in peer-reviewed journals and presented at national and international conferences. In short, no action will be taken without written consent from patients and doctors.Trial registration number> NCT03283735.