1898 Feasibility study of a hospital deprescribing intervention: CompreHensive geriAtRician-led MEdication Review (CHARMER)

Scott, S., Martin-Kerry, J., Pritchard, M., Alldred, D., Clark, A. B. ORCID: https://orcid.org/0000-0003-2965-8941, Hammond, A., Murphy, K., Colles, A., Keevil, V., Kellar, I., Patel, M., Sims, E., Taylor, J., Turner, D. ORCID: https://orcid.org/0000-0002-1689-4147, Witham, M., Wright, D. and Bhattacharya, D. (2024) 1898 Feasibility study of a hospital deprescribing intervention: CompreHensive geriAtRician-led MEdication Review (CHARMER). Age and Ageing, 53 (Issue Supplement_1). ISSN 0002-0729

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Abstract

Introduction: CompreHensive geriAtRician-led MEdication Review (CHARMER) is a behaviour change intervention to support geriatricians and pharmacists to proactively deprescribe inappropriate medicines with older adults in hospital. The intervention comprises: formulating a deprescribing action plan, workshops, benchmarking reports and weekly briefings between geriatricians and pharmacists. We assessed feasibility and acceptability of the CHARMER intervention and study processes. Method: A two-arm purposive allocation feasibility study was undertaken in four hospitals (three intervention, one control) in England in 2022. Data were collected to check completeness and quality, and assess intervention fidelity. Rapid qualitative analysis of staff and patient interviews, intervention implementation observations (action plan launch, pharmacist workshop and geriatrician videos), and study meeting minutes was undertaken. Results: Study data were feasible to collect, of sufficient completeness and quality. Geriatrician and pharmacist principal investigators managed intervention implementation. They were able to implement most intervention components with ease and fidelity. Principal investigators felt that dedicated support for intervention implementation would better equip them with the resource and expertise to fidelitously implement all intervention components. Detailed instructions for preparing the action plan and how it might be delivered were desired. Geriatricians and pharmacists who received the intervention found it acceptable. Pharmacists felt that the weekly briefings encouraged them to dedicate time to review medicines and raise with geriatricians, opportunities to deprescribe. Geriatricians indicated that participating in CHARMER allowed them to focus on deprescribing conversations with patients and they involved junior doctors more in the deprescribing process. Conclusion(s): The CHARMER intervention and trial processes were feasible and acceptable. Revisions to support intervention implementation include providing a template action plan for hospitals to adapt; funds for a project manager one day a week to work with CHARMER principal investigators for three-months to oversee implementation, and support from Eastern Academic Health Science Network in the definitive trial (winter 2023).

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Depositing User: LivePure Connector
Date Deposited: 04 Mar 2024 18:28
Last Modified: 04 Mar 2024 18:28
URI: https://ueaeprints.uea.ac.uk/id/eprint/94454
DOI: 10.1093/ageing/afad246.129

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