Aims. This study aimed to analyse patterns and communication of deprescribing recommendations made to GP’s in discharge summaries across six NSW public hospitals. The study sought to evaluate the prevalence of deprescribing recommendations, identify medication classes involved, explore patient and service characteristics associated with making these recommendations and describe the nature of communication in discharge summaries.
Methods. A retrospective cohort study was conducted using data from electronic medical records for patients aged >/= 65 years, admitted for > 48 hours, across six hospitals from January 4th - March 28th, 2022. 900 discharge summaries were analysed using an auto-extraction tool designed to identify deprescribing recommendations which were then manually confirmed by the authors. A logistic regression identified factors associated with the likelihood of deprescribing recommendations.
Results. Deprescribing recommendations were found in 30.5% of discharge summaries. The most frequently targeted medication classes were anti-infectives, opioids, and corticosteroids. Compared to patients under geriatrics, those admitted to other services were significantly less likely to have a deprescribing recommendation (adjusted Odds Ratio 0.54, 95% Confidence Interval 0.35–0.84, p=0.006). Other factors such as length of stay, age, gender, comorbidity burden, and interpreter requirements were not significant predictors. There was significant variation in the format and terminology used to communicate deprescribing recommendations.
Conclusions: This study highlights the variability in deprescribing practices across different medical services, with a particular emphasis on the role of geriatric care in promoting deprescribing recommendations to GP’s on discharge. Expanding geriatric principles to other specialties may enhance deprescribing practices across the healthcare system.