Achieving Better Outcomes through Deprescribing

Course overview

Polypharmacy is an issue for all patients over the age of 65 that escalates during end of life when patients are prescribed both maintenance medications for chronic disease states and symptom management medications. Upon admission to hospice, our pharmacy call center profiles at least 20 medications for each patient of which one-third are of questionable benefit to a patient at end of life. CMS continues to struggle with the high percentage of medications still being billed through Medicare Part D for patients on the hospice benefit. Discontinuing non-beneficial medications at end of life has proven to improve patient comfort and quality of life via data published in recent literature. Hospice clinicians can make an impact by framing medication discontinuation discussions therapeutically, clarifying that stopping or adjusting meds is done to prevent harm and promote patient well-being and time them on hospice admission, during changes in level of care and/or when a trust relationship is formed to ease transition.