'Deprescribing’ research tackles too many meds risk for older Australians
When clinical pharmacist and CQUniversity Master of Research student Sefunmi Odetola reviews medication charts in residential aged care, she regularly finds patients taking medicines prescribed for a very different stage of life.
Often prescriptions have remained in use for years despite changes in health, care needs and treatment goals – meaning medications are ineffective or could be doing harm.
"Through my work, I became increasingly interested in deprescribing and how decisions are made about medicines that may no longer be appropriate," Sefunmi explained.
Deprescribing is the process of reducing medications to improve safety and quality of life, but Sefunmi says medication reviews are rarely straightforward.
“It’s not simply about stopping medicines – the process must be individualised, and consider the patient’s health, preferences and care goals, and be monitored after any change.”
The Canberra-based researcher aims to better understand how medical and health care professionals contribute to medicine management.
Sefunmi hopes her findings will improve processes for nearly 200,000 people used residential aged care in Australia (Australian Institute of Health and Welfare, 2024).
Healthcare perspectives
As part of Sefunmi’s research, doctors and nurses working in Australian aged care facilities to share their experiences.
The research interviews will explore which outcomes matter most to clinicians, when pharmacists lead deprescribing initiatives.
“In my practice, I noticed that the outcomes used to determine the success of deprescribing did not always reflect what doctors and nurses caring for residents considered to be most important,” Sefunmi explained.
“Time pressures, access to clinical information, differences in professional perspectives and delays in communication can make collaboration more difficult, and it’s not always clear who is responsible for initiating, implementing and monitoring medication changes.
“Good communication and a shared understanding of the patient’s goals are vital.”
Avoiding polypharmacy
Taking five or more separate medications daily is classified as polypharmacy, and research shows it can lower quality of life by causing side effects, drug interactions, and a heavy management burden.
Sefunmi’s research aims to identify the outcomes that doctors and registered nurses consider most important when pharmacists lead deprescribing in residential aged care.
These may include clinical outcomes, quality of life, medication burden, resident or family experience, and practical aspects of implementing and monitoring medication changes.
“I hope the findings will help inform how future pharmacist-led deprescribing services are designed and evaluated, using outcomes that are meaningful to the clinicians involved in residents’ care,” she said.
Sefunmi is juggling her Master of Research with her work in clinical pharmacy, and with a busy family life.
She paid tribute to her spouse and children for their encouragement and practical support to balance the load, along with CQUniversity supervisors Adjunct Associate Professor Ashlyn Sahay, Professor Eileen Willis and Dr Katrina Lane-Krebs.
Doctors and registered nurses currently working in Australian residential aged care facilities can express interest in participating in the study, and sharing experience with deprescribing or medication-related decision making.
Confidential interviews will be online or in perspect, and participants will receive a $100 Prezzee digital gift card in recognition of their time.
Register to participate in the deprescribing study.
Explore more research pathways through CQUniversity’s Higher Degrees by Research.
