Reducing post-discharge potentially inappropriate medications amongst the elderly: a multi-centre electronic deprescribing intervention

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Read more about the project here.

Polypharmacy, or the concomitant use of five or more drugs, is a serious health concern affecting more than half of Canadians aged 65 years and older. Medications can be essential, but each additional one increases the risk of an adverse drug event (ADE). Polypharmacy is the number one identifiable risk factor for ADEs and Canada’s 1.1 million frail older adults are especially at risk. ADEs are responsible for nearly 27,000 hospital admissions annually in Canada and up to 20% of return visits to the hospital within 30 days of discharge. Many ADEs could be preventable or ameliorable through interventions to reduce inappropriate prescribing.

We created MedSafer, an electronic application, in order to automate some of the processes of deprescribing. At the time of hospitalization the patient’s medications and comorbidities, along with a measure of frailty, were entered into MedSafer, which generated an individualized, prioritized, deprescription plan targeting potentially inappropriate medications. The most responsible physician then chose to implement the deprescribing plan after discussion with the patient/caregiver.  In this webinar we will describe the project, the outcome of the CFN funding pilot study and the ongoing pan-Canadian study funded by the CIHR (

Todd Campbell Lee, MD, MPH, FRCPC is an attending Physician at the McGill University Health Centre, as well as an Associate Professor at McGill University. He is the Director of the Clinical Practice Assessment Unit of the McGill University Health Centre, a unit that focuses on research in high value healthcare, quality improvement and patient safety. Dr. Lee obtained his medical degree from the University of Toronto, where he also completed of his residency training in internal medicine and a fellowship in infectious diseases before receiving his Masters of Public Health from Harvard University. Dr. Lee is clinician-scientist supported by the Fonds de Recherche Santé Quebec and his interests include deprescribing, high value healthcare, quality improvement and patient safety.

Emily McDonald, MD, MSc, FRCPC is an Assistant Professor of Medicine at McGill University in General Internal Medicine and an Attending Physician at the MUHC. She completed her residency training and Masters in Epidemiology at McGill University as well as post-graduate training in patient safety and quality improvement at the University of Toronto. Along with Dr. Lee she was the recipient of a CIHR grant to study deprescribing of medications in at-risk hospitalized older adults. Dr. McDonald’s research focus in on polypharmacy and the implementation of deprescribing in older adults.