Primary care is an under-studied area of health and medicine, yet has the strongest evidence for links with improved population health outcomes. When the burden of treatment outweighs a patient’s capacity to benefit, the negative effects from taking too many drugs can impact the patient’s quality of life and waste healthcare dollars. At the same time, patient preferences and priorities for medications are often not communicated and considered in decisions. Through TAPER, we are assessing a structured and collaborative way to reduce the number of unnecessary medications a patient takes.
Studies are listed and linked below.
TAPER-RCT is mainly being implemented within the McMaster Family Health Team. A group of 360 participants aged 70 or older taking ≥5 long-term prescribed medications were randomized 1:1 to receive TAPER at the beginning of the study or six months later.
The main goal of the study is to see if TAPER can reduce the harmful effects of polypharmacy. A cost-utility analysis will be done. Qualitative data will be gathered about the patients’ and clinicians’ experiences throughout the process.
TAPER-P is being implemented in community pharmacies in Hamilton, Halton, and Niagara. A group of 75 participants aged 70 or older taking ≥5 medications were randomized 1:1 to receive TAPER at the beginning of the study or six months later.
The main goal of the study is to see if TAPER can reduce the harmful effects of polypharmacy. In addition, it examines whether implementing TAPER with community pharmacists as the point-of-entry can improve patient health outcomes and prescribing. Qualitative data will be gathered about the patients’ and clinicians’ experiences.
Team Approach to Polypharmacy Reduction to Improve Mobility: A Pilot Feasibility Study in a Long Term Care Setting
TAPER-LTC is being implemented across two long-term care facilities in Brampton, Ontario. A group of 80 long-term care residents aged 70 or older taking
≥5 medications are being recruited to receive TAPER.
The aim is to test the feasibility of implementing TAPER to reduce the harm of polypharmacy. In addition, it assesses whether medication-related mobility impairment (fatigue, pain, falls) can be reversed through medication reduction- among various other outcomes.
TAPER-F is a pilot study that tested the feasibility of implementing TAPER. A group of 39 participants aged 70 or older taking ≥5 medications were randomized 1:1 to receive TAPER at the beginning of the study or six months later.
TAPER appears to be addressing the harms of polypharmacy effectively without causing serious adverse events. It is feasible for pharmacists and physicians to collaborate to identify patients in need of deprescribing. Results from this study successfully informed a large, randomized control trial.