Medication Reduction for Aging

Age: 65+

Sex: Any

Trial Phase: Phase 4

Sponsor: University of Alberta

Must be taking: Long-term oral medications

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if reducing the number of medications can improve health for older adults. It focuses on seniors taking six or more long-term oral medications and seeks the lowest effective doses, particularly for medications treating blood pressure, blood sugar, or symptoms like heartburn. The trial will compare health outcomes between those who have their medications reviewed and adjusted and those who continue their usual care. Ideal participants are seniors aged 80 or older, living at home, and currently taking multiple medications. The goal is to enhance independence, reduce hospital visits, and improve quality of life for older adults. As a Phase 4 trial, the treatment is already FDA-approved and proven effective. This research helps understand how it can benefit more patients, offering participants a chance to optimize their medication regimen.

Will I have to stop taking my current medications?

The trial involves reviewing your current medications to see if any can be safely reduced, but it doesn't specify that you must stop taking them completely. You and your healthcare provider will work together to find the lowest effective doses.

What is the safety track record for medication minimization?

Research has shown that reducing medication, also known as deprescribing, can be safe and beneficial for older adults. Studies indicate that cutting back on unnecessary drugs lowers the risk of side effects and improves overall health. For instance, one study found that deprescribing increased survival rates, particularly for frail seniors. Another study highlighted that taking fewer medications led to better safety and quality of care by reducing adverse drug reactions.

Reviewing and reducing medications is generally considered best practice for older adults. This approach focuses on finding the lowest effective dose for the patient. Although it may seem like a small change, it can result in fewer hospital visits and an improved quality of life. Overall, evidence suggests that reducing medication is a well-tolerated and safe strategy for many seniors. ^{1 2 3 4 5}

Why are researchers enthusiastic about this study treatment?

Researchers are excited about the Medication Reduction for Aging trial because it explores a novel approach to managing medications in older adults. Unlike standard care, which often involves routine continuation of prescribed drugs, this approach focuses on reducing unnecessary medications through a dedicated review process with a healthcare provider. This "brown bag" medication review aims to enhance patient safety and well-being by minimizing potential drug interactions and side effects. By prioritizing medication minimization, researchers hope to improve health outcomes and quality of life for aging individuals.

What evidence suggests that medication minimization is effective for older adults?

Research has shown that reviewing and reducing medications, known as medication minimization, can benefit older adults. In this trial, participants in the "Medication Minimization" arm will have a dedicated visit with their primary care provider to review and potentially reduce their medications. One study found that checking and safely stopping some medications lowered the chances of older patients needing to return to the hospital. Another review showed that efforts to reduce the use of potentially inappropriate medications (PIMs) can be effective for older adults. This practice is already recommended for seniors, aiming to use the smallest effective doses to help them stay independent and improve their quality of life. Overall, using fewer medications is linked to better health outcomes, although results can vary. ^{6 7 8 9 10}

Who Is on the Research Team?

Scott Garrison, MD, PhD

Principal Investigator

University of Alberta

Are You a Good Fit for This Trial?

This trial is for individuals who are 80 years or older, take six or more long-term oral medications, see participating primary care providers regularly, and live independently (not in a nursing home). There are no specific exclusion criteria.

Inclusion Criteria

Community dwelling (i.e. not living in a nursing home or supportive living facility)

I am 80 years old or older.

Attached to participating primary care providers

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Medication Minimization

Participants have a dedicated medication minimization visit with their usual primary care provider to review and potentially reduce medication dosages.

6 months

1 visit (in-person) for medication review

Follow-up

Participants are monitored for safety and effectiveness after medication minimization.

18 months

What Are the Treatments Tested in This Trial?

Interventions

• Medication minimization

Trial Overview The study tests if reducing medication doses can benefit seniors. It involves reviewing patients' current medications to find the lowest effective doses for symptom relief and adjusting drugs that control blood pressure and sugar to safer levels.

How Is the Trial Designed?

Group I: Medication minimization Experimental Treatment 1 Intervention

Patients have a dedicated medication minimization visit with their usual primary care provider to which they bring all of their medications (a so-called "brown bag" medication review).

Group II: Usual Care Active Control 1 Intervention

Patients will continue to receive care as appropriate but no dedicated visit to review and minimize medications will be organized as a result of the study. Medications are free to be minimized during the normal course of care should the need arise.

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Published Research Related to This Trial

Elderly individuals (over 65 years) make up 12% of the U.S. population but account for 33% of all prescription drug use, highlighting their significant medication consumption.

The risk of adverse drug reactions is notably higher in the elderly due to factors like decreased organ function, changes in how drugs are processed in the body, and the complexities of taking multiple medications (polypharmacy), emphasizing the need for careful management of their drug regimens.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Principles of drug therapy in geriatric patients. Sloan, RW.[2013]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11289701/

Medication Optimization Protocol Efficacy for Geriatric ... In this randomized clinical trial that included 442 patients, the intervention did not reduce death, unscheduled hospital visits, or rehospitalization.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5325769/

Improving Medication Adherence and Health Outcomes in ... Of the 12 included studies, five interventions successfully improved both medication adherence and related health outcomes in older adults: two studies involved ...

3. agsjournals.onlinelibrary.wiley.com agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19035

Clinical impact of medication review and deprescribing in ... Medication review and deprescribing are associated with potential benefits in reducing hospital readmission rates among hospitalized older ...

4. frontiersin.org frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.777655/full

Effectiveness of Interventions to Reduce Potentially ... A huge number of interventions to reduce PIM have been proposed. This work aims to analyze the effectiveness of PIM interventions directed to older adults.

5. sciencedirect.com sciencedirect.com/science/article/pii/S2542454820300229

Treatment Effectiveness and Medication Use Reduction for ... This 2-year retrospective clinical cohort study examined treatment outcomes of 134 older adult patients 65 years or older with chronic noncancer pain who ...

6. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK600387/

Deprescribing To Reduce Medication Harms in Older Adults Deprescribing has the potential to improve multiple aspects of patient safety and quality of care, including by reducing drug burden, ADEs, and morbidity.

7. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2833713

Deprescribing in Community-Dwelling Older Adults One approach to minimize adverse outcomes is to proactively discontinue inappropriate medications.

8. bpspubs.onlinelibrary.wiley.com bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.16200

The effect of deprescribing interventions on mortality and ... Previous systematic reviews suggest that deprescribing may improve survival, particularly in frail older people.

9. link.springer.com link.springer.com/article/10.1007/s40266-025-01189-2

Medicine Optimisation and Deprescribing Intervention ... Outcome data were categorised into three categories: medication-related outcomes, clinical-related outcomes and safety outcomes. Both ...

10. effectivehealthcare.ahrq.gov effectivehealthcare.ahrq.gov/sites/default/files/related_files/mhs-IV-rapid-response-deprescribing.pdf

Deprescribing To Reduce Medication Harms in Older Adults ... One approach to minimize adverse outcomes associated with polypharmacy and. PIMs is to proactively discontinue inappropriate medications.