Home nurse reviewing prescription bottle with patient
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Patients who start a deprescribing intervention before admission to a post-acute care facility have fewer medications at discharge and at 90-day follow-up than their peers with usual care, according to the authors of a study published in JAMA Internal Medicine.

Their trial included 372 hospitalized adults 50 and older taking five or more medications who were scheduled to transition to post-acute care. Participants followed a protocol called Shed-MEDS developed at Vanderbilt University Medical Center. A pharmacist or nurse practitioner provided a comprehensive medication review and patient- or proxy-approved deprescribing recommendations. Deprescribing was initiated in the hospital and continued throughout a post-acute facility stay. A control cohort received usual care in both settings. 

Patients who received the intervention had an average of 14% fewer medications at post-acute facility discharge and 15% fewer medications at a 90-day follow-up compared with the control group. 

The Shed-MEDS protocol also was linked to a decrease in potentially inappropriate medications and fewer sedative and anticholinergic drugs, investigators reported. There was no evidence of adverse events.