Medication-related risk of harm and deprescribing in a geriatrics inpatient unit

Deprescribing has been proposed as a strategy to reduce medication-related harms in older adults. This audit assessed the medication-related risk of harm and patterns of deprescribing in patients admitted to a geriatrics unit. Medication lists and clinical indicators for medication-related harm were assessed on admission and at discharge from the unit. A significant number of patients (69.9%) were at high risk of medication-related harm on admission. The proportion of patients at high risk of inappropriate polypharmacy tended to increase from admission (65.2%) to discharge (82.6%) due to the initiation of opioids despite deprescribing occurring for cardiovascular medicines. The proportion of patients at high risk of medication-related falls reduced from admission (57.1%) to discharge (42.8%) due to deprescribing of cardiovascular medicines. However, there was minimal change in the risk of medication-related cognitive impairment or physical function. The incorporation of these indicators of medication-related risk into routine care has the potential to improve medication use in older hospitalized adults.