6 Using what matters to reduce medication overload: lessons from a nursing home learning collaborative

<h3>Description</h3> In 2022, a 1-year nursing home learning collaborative on deprescribing resulted in reducing the average number of medications administered per resident from 10.7 to 8.7. This may have reduced risk of adverse events but there was opportunity to further decrease medication overload by making deprescribing interventions more person-centered. Thus, the objective of our 2023 learning collaborative was to reduce high-risk medications by incorporating Age-Friendly Health System (AFHS) concepts, including ‘what matters’ (WM), into the curriculum. Seven sites participated by attending learning and coaching sessions, receiving deprescribing toolkits, and implementing 6-month interventions using QI tools and AFHS principles. Clinical faculty and AFHS experts supported the project. Prescribing data were collected before and after, along with perspectives on the facilitators and barriers. Our project data showed substantially less utilization of overall and targeted high-risk medications, post-curriculum. Some participants asked and used WM to residents to deprescribe but faced barriers (e.g. limited resource and/or buy-in). Using WM is a promising way to approach deprescribing, but to do so sustainably implementation barriers must be addressed.