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Deprescribing In Long Term Care

Reducing Avoidable Medication Related Health Problems Among Older Adults in Long Term Care Settings

SUNY Upstate Medical University in Collaboration with the Loretto Health System Funded by the New York State Health Foundation

This project addresses the opportunity to optimize the management of medications for older adults in long term care settings through what is called ‘deprescribing’ -- the process of intentionally stopping or reducing a medication dose to improve a person’s health and/or reduce their risk of adverse drug events.

Unlike other areas of health care, medication related risks, adverse drug events and related costs are predictable and preventable. Up to 30% of older adult hospitalizations are medication related and as many as 95% of nursing home patients have drug related health issues. While evidence-based medication guidelines are available, we lack evidence demonstrating the health benefits and economic value of incorporating these guidelines into practice workflow for long term care patients. 

This project focuses on vulnerable older adults in long term care settings, who are residents of the Loretto Health System’s Syracuse and Auburn skilled nursing facilities. Its objectives are to determine whether the introduction of deprescribing programs in these settings is cost effective in reducing medications and avoiding adverse drug events and hospital/emergency room admissions while lowering Medicaid costs.

Pending findings, the intent is to develop practice briefs on the project’s results for long term care providers and policy briefs for New York State policy makers with projections of potential savings to Medicaid.  The project will also contribute information to help move the field and best practices forward in understanding and developing effective approaches to deprescribing across health care settings.