4CPS-142 Pharmacotherapeutic recommendations and deprescription in elderly patients admitted to an acute a geriatric unit

<h3>Background and Importance</h3> Older patients with multimorbidity, frailty and polypharmacy have a high-risk of inappropriate medication prescribing (IP) that affects quality of life. Deprescription is a recognised strategy to optimise pharmacotherapy and reduce IP. <h3>Aim and Objectives</h3> To analyse the pharmacotherapeutic recommendations (PR) performed by the clinical pharmacist in patients admitted to an Acute Geriatric Unit (AGU) and the degree of acceptance by physicians. To quantify desprescription obtained through the PR performed. <h3>Material and Methods</h3> Retrospective and descriptive analysis of PR performed in daily clinical practice in an AGU between 01/09/2023 and 31/01/2024. Sociodemographic variables, sex, age, living situation, polypharmacy and reason for admission were collected. The number of PRs performed by the clinical pharmacist, the degree of acceptance by physicians and the number of deprescribing PR were also recorded. The number of patients with at least one deprescribed drug (dose reduction or treatment suspension) the percentage of the deprescribed drugs of the total number of medications and the most commonly drugs deprescribed were quantified. <h3>Results</h3> 209 patients were included, 70% female, mean age of 93(80–103) years old. 31% lived in nursing homes. 87% had polypharmacy on admission and 45% had hyperpolypharmacy. The most common reasons for admission were respiratory and urinary tract infections (58% and 16% respectively) and cardiac pathology (11%). At admission, 624 PRs were made in 195 (93%) patients. They were classified as: need (56.9%), effectiveness (0.6%), appropriateness (3.2%), safety (34.5%) and adherence (4.8%). Recommendations about deprescription were made in 81% of total PRs and 70% were accepted by the physician at discharge. 876 drugs were deprescribed in 160 (77%) patients at discharge with a median of 4 deprescribed drugs (73% were discontinuations and 27% were dose reductions). The most commonly deprescribed drugs were omeprazole discontinuation (6%), followed by paracetamol reduction(4%) and metamizole discontinuation (2%). <h3>Conclusion and Relevance</h3> Most patients received PRs, mainly deprescription which were accepted by the physician at hospital discharge. The most common deprescription performed by physicians was drug discontinuation and the most commonly deprescribed drug was omeprazole. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest