Developing a theory and evidence-based deprescribing model for older people in hospital; selecting intervention components and modes of delivery

Sion Scott, University of East Anglia

Medications have benefits and problems and this balance can change over timeAs people get older, medications prescribed when they were younger may not be suited anymore. This is because the medications are more likely to have problems like side effects. ‘Deprescribing’ involves patients and healthcare professionals agreeing together to stop medications that are not suited. 

Research shows that half of patients in hospital are prescribed at least one unsuitable medicationOur own research shows that deprescribing does not happen much in hospital. 

Healthcare professionals think hospitals are a safe place for deprescribing because patients are closely monitored. We asked 150 older people and caregivers for their views and nine out of ten said they were happy with deprescribing in hospital. 

Hospital pharmacists and doctors have told us they want to do more deprescribing but find it hard for reasons like not knowing how best to start the conversation with patients about stopping medications. We have worked with pharmacists and doctors to understand the challenges to deprescribing and think of solutions. We now have a long list of ideas that might help with deprescribing. The next step is to choose the best ideas to help with deprescribing in hospital and put these together into a service plan. 


To produce service plan for hospital pharmacists and doctors to work with patients and caregivers to deprescribe medications 


  1. Search for studies that have tried deprescribing and understand which parts of the plan have worked and which have not
  2. Present the ideas from our previous work and from objective 1 to hospital doctors and pharmacists for them to choose the ones that are most helpful to them for deprescribing in hospital 

For objective 1, we will search for studies that have tried deprescribing. We will then look to see which of these studies were able to show deprescribing working and which failed to show deprescribing working. Finally, we will look at what was done in the studies to understand which parts have worked and which have not worked. This will tell us which parts to consider using in our service plan. 

For objective 2, we will present the ideas from our previous work and from objective 1 to a group of hospital pharmacists and doctors who would be users of our service plan. We will ask these people to tell us which parts to include in our service plan to help them with deprescribing. 

We have worked with a patient and carer of someone who takes medications on this application and they will continue to work with us if funded. Their feedback is that the research will develop an important tool that could lead to better patient outcomes. 

We will communicate the research to patients and healthcare professionals by presenting at a Clinical Research Network meetingWe plan to deliver an interactive workshop at a Patients Association conference where we will ask for feedback on the service planWe will also publish the findings in research journals. 

This project was due to run from October 2018 to October 2019