Deprescribing in older patients with hyperpolypharmacy: a cluster-randomised trial in primary care.

Authors

Gert Baas, Mette Heringa, Sanne Verdoorn, Henk-Frans Kwint, Eman Badawy, Jacobijn Gussekloo, Jako Burgers, Petra Denig, Marcel L Bouvy

Published in

Age and ageing. Volume 55. Issue 7. Jul 02, 2026.

Abstract

Polypharmacy increases the risk of adverse drug events and potentially preventable hospital admissions. Deprescribing may reduce medication-related harm, and a clinical medication review (CMR) provides an opportunity to support this.
To investigate the effect of a deprescribing-focused CMR by trained pharmacists on the number of reduced and stopped medications among patients aged ≥75 years with hyperpolypharmacy using multidose-drug-dispensing (MDD)-systems.
In this cluster-randomised controlled trial, pharmacists were trained to perform a deprescribing-focused CMR, while control pharmacies provided usual care. Eligible patients were aged ≥75 years, had hyperpolypharmacy and used MDD. Dispensing data were used to determine the number of reduced and stopped medications per patient after 6 months (primary outcome). Secondary outcomes were: total number of medications, health problems and quality-of-life (EQ-5D-5L, EQ-VAS). A generalised linear mixed model was used for the primary outcome.
A total of 318 patients from 58 pharmacies were enrolled (155 intervention, 163 control). At 6 months, patients in the intervention group had significantly more medications deprescribed than those in the control group (mean 2.5 vs. 1.7 per patient; mean difference 0.79, 95% CI 0.29-1.28; P = .002). There was no significant between-group difference in the total number of medications at 6 months (intervention -0.30 vs. control +0.12; P = .108). No significant differences were observed in health problems or quality-of-life.
Deprescribing-focused CMRs by trained pharmacists successfully increased reduction and stopping of medications in older patients with hyperpolypharmacy using MDD-systems, while no changes in health problems or health-related quality of life could be observed over 6 months.

PMID:
42472621
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

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