Jamaica Hospital Nursing Home, along with six other New York nursing homes, participated in a partnership with the United Hospital Fund (UHF) to tackle the issue of polypharmacy, the practice of prescribing an excessively high number of medications to long-term care residents. The initiative aims to reduce health risks of overprescribing for residents through a process called “deprescribing,” or decreasing the usage of inappropriate or ineffective medications.
A report assessing the results of the partnership, Reducing the Risk: Year 1 Report of the Polypharmacy in Nursing Homes Learning Collaborative, showed that participating nursing homes reduced the average number of medications prescribed to patients from approximately 11 to 9. The number of residents taking 10 or more medications also decreased across all participating facilities by 16%.
Deprescribing efforts focused on reducing medications that provided limited benefits and increased patients’ risk of experiencing harmful side effects, such as dizziness and falling. Jamaica Hospital Nursing Home specifically worked to deprescribe antihypertensives, proton pump inhibitors, and multivitamins.
“Antihypertensives and proton pump inhibitors are used very frequently in most nursing homes and hospitals,” said Louis Kaplan, the Assistant Director of Pharmacy at Jamaica Hospital Medical Center, who monitored the rate at which the targeted medications were prescribed to residents. “We suspected that it may not be necessary to continue their use for many of our patients.” Kaplan added that multivitamins were also targeted by the nursing home’s deprescribing efforts because of the sufficient nutrition patients already receive through their regular meals, making these supplements redundant in many cases.
Dr. Kaushik Doshi, the Medical Director of Jamaica Hospital Nursing Home, worked with doctors, pharmacists, and nursing staff to incorporate safe deprescribing guidelines from the UHF into the nursing home’s standard patient care practices. A key aspect of this initiative involved the introduction of helpful educational tools, such as electronic medical record alerts indicating whether the targeted medications were appropriate to prescribe continuously for certain patients.
“Physicians can be hesitant to stop medications, even when there’s no clear indication that they’re necessary beyond a certain point,” said Dr. Doshi. “This is an aspect of healthcare that needs to change, not only here, but across all facilities and organizations.”
Jamaica Hospital is proud of the results achieved through this partnership and congratulates everyone who participated in this initiative for the work they’ve done so far. We look forward to seeing the continuing impact of these practices for our patients and care provider teams in the future.