(089) Are drugs discontinued after hospital-based medication reviews in older adults? A nationwide register-based study in 2022

Background: Medication reviews have been advised for older adults (aged ≥75 years) with polypharmacy (≥5 concurrent drugs) in Sweden since 2017. Medication reviews conducted in hospitals or specialized outpatient clinics are registered in national register data. To date, there is little known about the changes in drug use after registered medication reviews in regular clinical practice.

Objectives: We aim to investigate changes in number of used medications and identify the drug classes most frequently discontinued after a medication review in persons 75 years and older.

Methods: We used the nationwide Swedish Prescribed Drug Register individually linked to the National Patient Register to identify adults 75 years and older with a medication review in 2022. Medication use was defined as all medications dispensed in the three-month window before and after the date of the medication review. We estimated the change in number of medications before and after medication review for the overall population, and for sex and age groups. We will also list the most frequently discontinued medication classes.

Results: We identified 137,096 older adults with a registered medication review in 2022, (54% females, median age 82), corresponding to 15% of persons 75 years and older. Overall, 38% used a lower number of drugs after the medication review. The mean reduction of number of drugs was -0.3 after the medication review (7.7 drugs before vs 7.4 after). Men and women and all age groups showed a similar reduction in number of medications after the medication review. Among persons aged 95 years and older, persons undergoing medication review used a lower number of drugs than younger age groups both before and after the review. We will further analyze the medication classes most often discontinued after medication review.

Conclusions: A small proportion of persons 75 years and older had a medication review performed at a hospital in 2022. There was a slight reduction in the number of used drugs after undergoing a medication review.