{
  "abstract": "Background and Importance Pluripathological Patients (PP) frequently experience extreme polypharmacy, leading to an increased unnecessary medication burden.Aim and Objectives To analyse low therapeutic value drug (LTVD) prevalence in patients attending the multidisciplinary Pharmacy-Internal Medicine PP consultation. To describe the pharmaceutical interventions (PIs) and their acceptance (by internist and patient), and to assess the polypharmacy degree in the sample.Material and Methods This was a retrospective descriptive study (28 March 2023, to 7 March 2025) of patients who attended the PP consultation at least once. Variables collected from the electronic medical record included demographics, follow-up parameters, the number of chronic medications, and key pharmacological data (LTVD use, category, duration, and PIs). LTVD examined were psychoanaleptics, SYSADOAs, vasoprotectors, topical NSAIDs, peripheral vasodilators, mucolytics, prokinetics, antioxidants and phytotherapeutics.Results 141 patients were included (mean age 83,8 ± 6,6 years; 36,9% women), with a median follow-up of 4,7 months. The mean number of chronic medications was 12,7±4,0. Extreme polypharmacy (≥10 drugs) was observed in 113 patients (80,1%), polypharmacy (5–9 drugs) in 26 patients (18,1%) and absence of polypharmacy (<5 drugs) in two patients (1,1%). The prevalence of patients using LTVD was 24 (17%). Treatment duration data were available for 18 patients, with a median of 346 days (6–4657 days). The most frequently prescribed LTVD were mucolytics (13 cases, 48,1%) and peripheral vasodilators (five cases, 20,8%). Acetylcysteine was the most commonly used mucolytic (11 cases). Other LTVD categories had isolated prescriptions (one case each): topical NSAIDs, vasoprotectors, psychoanaleptics, prokinetics, phytotherapeutics and antioxidants. Twenty patients on LTVD had extreme polypharmacy. Sixteen PIs recommending deprescribing were conducted and all proposals were accepted by the internist and the patient. Deprescribing included six mucolytics and one case each of topical NSAID, antioxidant, phytotherapeutic, psychoanaleptic and vasoprotector.Conclusion and Relevance The multidisciplinary approach between Pharmacy and Internal Medicine enabled the identification of LTVD prescriptions in 20% of patients, being mucolytics the most frequently prescribed category. Despite their low therapeutic value, some treatments were used long-term. The high prevalence of extreme polypharmacy suggests that deprescribing LTVD is an effective, simple strategy to reduce pharmacological burden, as it requires no tapering. Furthermore, these deprescription proposals were highly accepted by both internists and patients.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Hospital Pharmacy, Galdakao, Spain"
      ],
      "name": "G Miron"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Hospital Pharmacy, Galdakao, Spain"
      ],
      "name": "L Menendez"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Hospital Pharmacy, Galdakao, Spain"
      ],
      "name": "L Torio"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Hospital Pharmacy, Galdakao, Spain"
      ],
      "name": "E Paredes"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Internal Medicine, Galdakao, Spain"
      ],
      "name": "M Aznal"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Internal Medicine, Galdakao, Spain"
      ],
      "name": "J Bascones"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Internal Medicine, Galdakao, Spain"
      ],
      "name": "H Fernandez"
    },
    {
      "affiliations": [
        "Galdakao-Usansolo Hospital, Internal Medicine, Galdakao, Spain"
      ],
      "name": "L Urrejola"
    }
  ],
  "title": "4CPS-265 Deprescribing in practice: multidisciplinary review of low therapeutic value drugs in elderly patients",
  "uid": "b4fe446d-7914-5e02-a96a-1ed5e5cc9902"
}