Polypharmacy is common among multimorbid adults and associated with increased morbidity and mortality. Excessive polypharmacy (ie, ≥10 medicine) is strongly associated with inappropriate medication use, but little is known about attitudes toward deprescribing in patients with excessive polypharmacy. We surveyed 100 Danish individuals aged 65 years and above with ≥10 prescribed medications, using the validated Patients’ Attitudes Towards Deprescribing (PATD) instrument. Most participants (81, 81%) thought they took a large number of medications, and 79 (79%) believed that their medications were necessary. Even so, 85 (85%) reported that they would be willing to stop taking one or more of their regular medications if their doctor told them they could, and 11 (11%) felt that they took at least one regular medication that they no longer needed. When presented with visual presentation of various amounts of tablets and capsules, 62 (62%) of participants reported that they would be comfortable taking fewer medications than they did. Forty‐two (42%) participants had experience with stopping a regular medication. Almost all participants (92%) wanted to receive follow‐up by various means if a medication was discontinued. Forty‐one (41%) participants were interested in a consultation at an outpatient clinic specializing in polypharmacy. Overall, the answers to the PATD questionnaire suggest that our cohort of Danish, multimorbid outpatients with extensive polypharmacy have a high confidence in their healthcare providers for medication‐related decisions, even though some feel that they are taking more medications than they would like to and feel that some medications may be unnecessary. Our results underline the need for healthcare providers to offer medication reviews in patients with multimorbidity.

Polypharmacy increases the risk of hospitalization but may be reduced by medication review. The study objective is to describe and evaluate a method for conducting medication review in general practice by an interdisciplinary medication team of pharmacists and physicians—in this case conducted by a team from the Department of Clinical Pharmacology—based on information concerning medication, diagnosis, relevant laboratory data and medical history supplied by the general practitioner. We discussed the medication review with the patients’ general practitioners and received feedback from them regarding acceptance rates of the recommended changes. Ninety-four patients with a total of 1471 prescriptions were included. A medication change was recommended for nearly half of the prescriptions (48%); at least one change of medication was recommended for all patients. The acceptance rate for recommended medication changes was 55%, corresponding to a mean of 4.2 accepted recommendations per patient. For 18% of all 1471 prescriptions, the general practitioner agreed either to discontinue (stop the medication completely) or reduce the dose of the medication. This method is thorough, but since it requires several healthcare professionals, it is rather time-consuming. There is a need to support medication review in general practice, but although this method may be too time consuming in most cases, it may nevertheless prove to be a useful tool managing the most complicated patients.

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Background Medicines account for a large part of the budget in Danish hospitals. National and regional actions are initiated to control drug expenses. Local initiatives aim at involving doctors, nurses and pharmacy staff in taking everyday responsibility for the rational use of drugs. Purpose To establish systematic and documented cooperation between the Local Drug and Therapeutics Committee, the clinical staff and the pharmacy staff to systematically identify and intervene on avoidable medicines expenses. Materials and Methods 10 focus areas were identified: Handling free-of-charge drugs, systematic feedback from top-up-service, the staff’s (unofficial) use of medicines, reanalysis of statistical material on drug use, input from other pharmacy departments, analysing the use of the 120 most expensive drugs, analysis of disposed medicines, emptying vials (expensive drugs), shift from IV to oral antibiotics, and use of the patients’ own medicine, when possible. Through a systematic approach and co-operation on all levels of the organisation, the 10 focus areas were implemented in everyday practise at the hospital. Results The results were recorded in a report to the Local Drug and Therapeutics Committee in January 2012. A financial estimate was made for 4 out of 10 focus areas. The total result for the 4 intervention areas amounts to a saving of DKK 1,154,500 (€155,00)/year. The saving is based on a conservative estimate. For the remaining six focus areas interventions are still taking place. In 2012 the initiative is spreading to other hospitals in the Capital Region. Conclusions Through systematic and well-documented cooperation between the Local Drug and Therapeutics Committee, the clinical staff and the pharmacy, it has proved possible to save a considerable amount on the total hospital budget. No conflict of interest.