Team approach to polypharmacy evaluation and reduction for general practice patients with dementia: the Australian TAPERDem study.

Authors

Christopher Etherton-Beer, Amy Theresa Page, Hui Wen Quek, Lynne Parkinson, Vasi Naganathan, Gillian Caughey, Julie Redfern, Rhonda Clifford, Sarah Hilmer, Dee Mangin

Published in

Therapeutic advances in drug safety. Volume 17. Pages 20420986261464335. Epub Jul 10, 2026.

Abstract

Polypharmacy is common in people with dementia but may be insufficiently tailored to personal preferences and goals, particularly in the presence of a life-limiting condition.
To evaluate the effectiveness of pharmacists working with general practitioners (GPs) to optimise medicine regimens and health outcomes of people with dementia by applying the Medication Appropriateness Tool for Comorbid Health Conditions During Dementia (MATCH-D) as part of a structured Team Approach to Polypharmacy Evaluation and Reduction (AusTAPER).
Randomised controlled trial.
This study was conducted in Perth, Western Australia, with 12month follow‑up. The intervention was a collaborative medicine review that included a medicines history, interview by a research pharmacist, and a case conference with the participant's GP. Outcomes included medicines regimen, emergency department presentation, hospitalisations, and health outcomes at 12 months.
Overall, 19 GPs and 31 participants were recruited (five directly; 26 through GP practices). The pharmacist spent an additional mean of 5.5 hours with intervention participants. At baseline, the median number of regular medicines was 8.5 (IQR 3) in the control group and 10 (IQR 7) in the intervention group, and at 12 months, 11 (IQR 4) and 9.5 (IQR 5), respectively. Emergency department presentations were observed for 9/16 (56%) control and 10/15 (66%) intervention participants, with a median of 1 (IQR 1.5) versus 1 (IQR 4) presentations (z = 1.18, p = 0.25). Eight participants in each group had at least one day of unplanned hospital admission with a similar length of stay (0.5 (IQR 5) versus 1 (IQR 9) days; z = 0.44, p = 0.67). Quality of life, physical function, cognition, frailty, and falls were similar between groups.
Over 12 months, participants in both groups had similar medicine use, outcomes and quality of life. It was feasible to recruit people with dementia, and their doctors, to a medicine review intervention.
This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR; ACTRN12619000453189) on 19 March 2019.

PMID:
42436735
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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