Date of Award
3-2025
Degree Type
Dissertation
Degree Name
Doctor of Nursing (ND)
Department
Nursing
Chair
Roberta Durk-Gomez DNP, APRN, PNP-PC
Abstract
Background: Polypharmacy is a growing concern in geriatric medical care, increasing the risk of adverse drug events (ADEs), cognitive decline, falls, and hospitalizations. Multiple prescriptions result in potentially inappropriate medications (PIMs), leading to a prescribing cascade and medication overload for many patients. Numerous medications are deemed unnecessary or not appropriate, decreasing the quality of life. The lack of standardized deprescribing tools in clinical practice contributes to continued polypharmacy-related complications. The " project, was implemented at a PACE (Program of All-Inclusive Care for the Elderly) facility to improve medication management, patient safety, and quality of life through structured deprescribing interventions.
Methods: This quality project utilized tools such as MedStopper, Beers Criteria, and STOPP/START guidelines to identify and reduce PIMs over an 8–10-week period. The Knowledge-to-Action (KTA) Framework and the Plan-Do-Study-Act (PDSA) model guided implementation.
Results: The deprescribing intervention led to significant improvement in medication management, patient outcomes, reduced medication burden, improved cognitive function, and decreased adverse drug events.
Conclusion: Deprescribing is a valuable quality improvement method for managing polypharmacy in older adults. This project demonstrates that structured deprescribing can be effectively used in elderly care, aligning with the current Centers for Medicare & Medicaid Services (CMS), 4Ms Framework to provide holistic, patient-centered care. Future efforts should focus on developing user-friendly deprescribing tools that integrate with electronic health records (EHRs), enhance provider training and awareness, continue research on long-term deprescribing outcomes, and improve accessibility for U.S. and international providers. I encountered several deprescribing programs currently available solely to Australian, New Zealand and Canadian residents.
Recommended Citation
Villarreal, Vivian L., "Deprescribing: The Skill of Less Pills" (2025). Cohort XIII. 5.
https://scholarworks.utep.edu/cohort_13/5