Factors Associated With Potentially Inappropriate Medication Use and Deprescribing Among Patients Receiving Home-Based Hospice Care.

PurposeThis study aimed to examine the factors associated with potentially inappropriate medication (PIM) use and the deprescribing among home hospice patients in Taipei, Taiwan.MethodsWe analyzed 101 home hospice patients from a Taipei City hospital from 2016 to 2022, using 2 significant PIMs which are identified by the OncPal guideline and STOPPFrail version 2 respectively. Logistic regression and Cox proportional hazards regression were used to analyze factors associated with PIMs and the deprescribing.ResultsOf the 101 participants, about half of the patients were prescribed at least 1 of the 2 PIM at the beginning of the program. 41.6% had excessive polypharmacy and 29.7% received nasogastric tube feeding. The common drug of the both PIMs included antihypertensives, antiulcer agents, vitamins and statins. We found the factor associated with using both PIMs is excessive polypharmacy, with adjusted odds ratios of 5.87 (95% Cl: 2.14-16.08) for STOPPFrail and 10.39 (95% Cl: 3.38-31.99) for OncPal respectively. The discontinuation rate is about 30%. A negative association was found between nasogastric tube feeding and PIM deprescribing, with adjusted hazard ratios of 0.23 (95% Cl: 0.07-0.82) for STOPPFrail and 0.08 (95% Cl: 0.02-0.46) for OncPal.ConclusionThis study demonstrates a high prevalence of PIMs among home-hospice care patients, with PIMs being less likely to be deprescribed in those receiving nasogastric tube feeding. The further research may be warranted to minimize use of PIM to enhance medication safety for patients.