Effectiveness of polypharmacy measures consisting of a pharmacist check followed by a multidisciplinary team review in patients with poly-pharmacy admitted to a neurology ward

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Patients with neurological disease are at high risk of polypharmacy. We previously reported that a countermeasure against polypharmacy which combined a pharmacist check followed by a multidisciplinary team review was useful for diabetes patients with polypharmacy. We evaluated this polypharmacy countermeasure in neurology patients with polypharmacy admitted to our neurological ward. A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included neurology patients taking six or more drugs on admission to the neurology ward between June 2021 and April 2023. Of 435 patients admitted to the neurology ward, 24.4% (106/435) [≥65 years old, 28.3% (79/276) patients; < 65 years old, 16.7% (27/159) patients] were taking six or more drugs at admission. Prescription content was optimized in 62 patients, and a total of 212 drugs were discontinued. The median number of medications significantly decreased from 9.0 (interquartile range, 7-10) at admission to 8.0 (interquartile range, 6.25-10) at discharge (p < 0.001). On multivariate analysis, the number of drugs taken on admission and length of hospital stay were significant factors which contributed to drug reduction, while concomitant use of immunosuppressive drugs was a significant factor in increasing the number of drugs. This countermeasure for polypharmacy, which combined a pharmacist check followed by a multidisciplinary team review, was useful in older and non-older patients with polypharmacy on a neurology ward.

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