People on hemodialysis have a very high pill burden, at 12±5 average daily medications. While many of these medications are important for treating or managing health conditions, some of these medications may not be necessary for all individuals on hemodialysis. What’s more, a high pill burden such as this is associated with an increased risk of certain problems (e.g., adverse drug reactions, drug-drug interactions, increased risk of cognitive impairment and hospitalizations).
A Can-SOLVE CKD research project, called STOP Med-HD, has created a novel clinical deprescribing tool that clinicians can use to reduce the number of medications that are prescribed for patients on hemodialysis. Along with the deprescribing clinical tool for clinicians, the research team worked closely with patient partners to create information tools (e.g., bulletins, videos) to help patients understand which medications can be safely stopped.
An initial pilot of STOP-Med showed that the tool is useful for decreasing the pill burden of hemodialysis patients, and now the research team is working to implement it in more hemodialysis clinics across Canada. During this second stage of the project, they are studying factors that facilitate or deter adoption of the tool, and will use this information to ensure broader implementation of the deprescribing program into clinical practice. As a result, patients on hemodialysis throughout Canada will experience a lower pill burden and better quality of life.