Polypharmacy is the overprescribing of inappropriate medications. United Hospital Fund has been awarded a grant from the Mother Cabrini Health Foundation to address the problem of polypharmacy in long-term care residents of nursing homes.

Why This Is Important

While there is no clear definition of polypharmacy based on a particular number of prescribed medications, polypharmacy refers to the overprescribing of inappropriate medications, some of which may be harmful. Crucially for nursing homes, frail elders are even more susceptible to the harms of polypharmacy than the general population, and poor outcomes–such as adverse drug events, falls with injury, hip fractures, cognitive impairment, and hospitalizations–are not uncommon. However, there is growing evidence of the effectiveness of “deprescribing” practices, which decrease the use of inappropriate medications and ultimately reduce the burden of polypharmacy.

Our Work

UHF is sponsoring a learning collaborative with six nursing homes in New York City to address the problem of polypharmacy. Using a quality improvement approach, the collaborative participants will design and implement deprescribing interventions, with focus on medication categories that are known to be commonly overprescribed and that place long-term nursing home residents at risk.

With the support of clinical faculty and UHF staff, the nursing homes will participate in structured learning sessions, receive coaching to develop and implement their interventions, choose the medication categories most relevant to their resident population, and collect data to assess the impact of their interventions.

By the end of the collaborative, UHF will publish its findings, together with tools and recommendations for other organizations wishing to develop their own deprescribing initiatives.

Contact: Alice Ehrlich and Joan Guzik