Pilot studies from the US report that pharmacist-overseen deprescribing reduces exposure to high-risk anticholinergics.

The investigation assessed clinic- and telephone-based interventions, during which pharmacists focused on medications with an Anticholinergic Burden (ACB) score of at least 2 (e.g. oxybutynin, carbamazepine and amitriptyline [see acbcalc.com]). 

Eighteen patients at an ageing brain care clinic aged 55 years and older were referred to a face-to-face meeting with a pharmacist. During telephone-based consultations, a clinical pharmacist called 24 patients aged 65 years and older without referral.

Clinic patients received 35 anticholinergics with an ACB score of at least 2. The pharmacists considered that deprescribing was appropriate for 24 anticholinergics. Phone-based consultations identified that deprescribing was appropriate for 24 anticholinergics and 12 were deprescribed.

“Tackling deprescribing has not been easy,” said lead author Noll Campbell from the Regenstrief Institute and Purdue College of Pharmacy, Indianapolis.

“That pharmacist-centric deprescribing models work so well does not surprise me because pharmacists are well-suited for the task. They are knowledgeable about medications, often have a close relationship with the patients and are well trained to communicate with providers.”

 (Journal of the American College of Clinical Pharmacy DOI 10.1002/jac5.1682)