Project #186:
Impact of COVID-19 on polypharmacy and deprescribing patterns in dementia patients

Many older adults, especially those with dementia, take multiple medications simultaneously (polypharmacy). This can increase the risk of negative outcomes like falls, confusion, adverse drug reactions and cognitive impairments. Medication reviews are a good opportunity for clinicians to improve medication safety by considering the range of medications being taken by a patient. However, the effectiveness of medication reviews for stopping medicines (deprescribing) remains poorly understood.

The COVID-19 pandemic was very disruptive to healthcare delivery and resulted in a significant reduction in many routine services, including medication reviews. Additionally, communication and relationship challenges stemming from reduced face-to-face appointments contributed to increased difficulty managing medications for people with polypharmacy . Many NHS services remain under strain since the pandemic, but it is not known if difficulties with medication management have persisted.

This is a particular concern for patients with dementia because they are especially at risk of the negative effects of overmedication. The symptoms associated with dementia can further contribute to a higher risk of poor drug management in this this population. Furthermore, dementia patients are frequently excluded from clinical trials, leaving a gap in evidence-based guidelines for medication management in this population.

This study will investigate deprescribing trends in dementia patients following medication reviews between 2015 and 2024. We will examine which medications are commonly prescribed and deprescribed, and whether medication reviews are associated with successful deprescribing. We will explore how the COVID-19 pandemic, which disrupted routine healthcare, impacted these trends. By identifying which medications are frequently stopped and understanding the effectiveness of medication reviews, we can develop better strategies to reduce harm from polypharmacy and improve the quality of life for people living with dementia.