1081 Burrard Street
Dr. Rita McCracken
Associate Head and Clinician Scholar, Dept. of Family Practice, PHC
Abstract: Frailty and advancing age are significant factors in adverse drug events and polypharmacy has been found to be a stand-alone risk factor for higher mortality and morbidity. An average elder in a B.C. nursing home is prescribed nine medications. A small, but growing, body of research suggests that reduction of interventions, including medications and hospitalizations, may produce improved outcomes for elders. Research designed to test these “less is more” hypotheses have been described as “de-prescribing trials,” where the intervention being measured for effect is in itself an avoidance of a specific intervention that might be used on a younger or more well patient. However, research on frail elders, especially those affected by dementia, is complicated by established research consent processes. Despite an acknowledged need for more appropriately generalizable research to this population, it is rarely happening. We will discuss RCT design issues and potential methods solutions to allow for a rigorous assessment of whether treating chronic diseases to frailty-appropriate targets would affect quality of care outcomes (e.g. stroke, hip fracture, mortality) and possibly reduce the overall number of medications prescribed to these patients.
This talk is open and will include a light lunch.