Team Approach to Polypharmacy Reduction in Long-Term Care (TAPERLTC). RCT feasibility study: integrating families’ experiences

Medications can help older adults but can also harm them. A lot of visits to emergency rooms and hospitals are due to medications. Older adults living with frailty tend to have many health problems, but are at risk of harm from medications. This makes it hard to get older adults the treatments they need and keep them safe from the harms from medications.

About this project

Previous research has shown the benefits of stopping medications older adults no longer need. Even so, healthcare professionals do not do this as well as they could. Our goal is to make a tool for pharmacists who work with doctors and nurses that will help older adults safely stop medications that are no longer needed.

We will use knowledge and tools that are already known and adapt them to put into practice. In the first six months our team, which includes older adults and their families, pharmacists, doctors, nurses, and healthcare policymakers will work together to develop a tool that pharmacists can use to help older adults stop medications that are no longer needed. In the remaining 10 months, we will use the tool in primary healthcare teams and nursing homes. Overall, we expect that by using the tool pharmacists will be able to help reduce the number of pills people take, reduce drug costs, reduce harms from medication use and improve quality of life for older adults living with frailty and their loved ones.

Project Team

Principal Investigators:

Dee Mangin, MBChB (Otago), DPH (Otago), FRNZCGP (NZ), Professor & Associate Chair, Research, McMaster University

Co-Investigators:

Gina Agarwal, MBBS(UK) MRCGP(UK) CCFP PHD (Epidemiology), Associate Professor, McMaster University

Henry Siu, MSc, MD, CCFP, Assistant Professor, McMaster University

Lehana Thabane, BSc, MSc, PhD, Professor & Associate Chair, Director, Biostatistics Unit, McMaster University

Julie Richardson, BSc, MSc, PhD, Professor, McMaster University

Mat Savelli, BA, MSc, DPhil, Assistant Professor (CLA), McMaster University

Parminder Raina, PhD, Professor & Canada Research Chair in GeroScience (CIHR), McMaster University

Justin Lee, BScPhm, ACPR, MD, FRCPC, PhD Candidate, Clinical Scholar, McMaster University

Jane Jurcic-Vrataric, RPh, BSc(Pharm), MSc, CDE, Pharmacist, McMaster Family Practice

Alan Cassels, BA, MA, Adjunct Professor, University of Victoria

Scott Garrison, MD, PhD, Associate Professor, University of Alberta

Anne Holbrook, MD, PharmD, MSc, FRCP(C), Professor, McMaster University

Diana Sherifali, RN, PhD, CDE, Associate Professor, McMaster University

Cathy Risdon, BA, MD, CFPC, DMan, FCFP, Professor & Associate Chair, McMaster University

James Gillett, PhD, Acting Associate Dean, McMaster University

Kiska Colwill, RPh, BScPharm, CDE, Pharmacist & Assistant Clinical Professor, McMaster Family Practice

Joanne Ho, MD, FRCPC, MSc, Assistant Professor, McMaster University

Jobin Varughese, MD, CCFP, Assistant Clinical Professor & Residency Program Site Director  (Brampton ), McMaster University

Johanna Trimble, BA, Patients for Patient Safety Champion, Canadian Patient Safety Institute

Lauren Griffith, PhD, Associate Professor, McMaster University

Kristina Frizzle, BscPharm, Pharmacist, Stonechurch Family Health Centre

James McCormack, BSc, BSc (Pharm), PharmD, Professor, University of British Columbia

Collaborators:

Larkin Lamarche, MA, PhD, Research Associate, Assistant Professor, McMaster University

HQP/Trainees:

Alison Ross, MA, BA, PhD Candidate, McMaster University

Jenna Parascandalo, MPH Candidate, McMaster University

Partners:

Peter Wood, DataBasedMedicine Americas

Project Contact: Dee Magin–mangind@mcmaster.ca

CAT2017-20

Keywords: Polypharmacy, long-term care, multimorbidity, mobility, patient-focused care, frailty, drug safety, deprescribing