The Feasibility and Acceptability of a Collaborative Deprescribing Intervention to Reduce Anticholinergic Burden Among Hospitalised Older Patients

NCT07489677 | Completed DMC

• 1 other identifier: DARTMED2091
• Study Type: interventional
• Target: 21
• Locations: 1 country
• Sites: 1

Brief Summary

Why this research is important? It is estimated that over one third of all older adults are prescribed medication which are known to have "anticholinergic" side effects. These anticholinergic side effects can include an increased risk of falls, delirium, and memory problems. People who have a high number of anticholinergic medications have an increased risk of these side effects. This can be measured as their anticholinergic burden (ACB). Several tools have been developed to assess the ACB score, by checking a person's medication list, with the aim of reducing these medications where possible (deprescribing). The study aim The project team worked with a company to design an online tool which can calculate the total ACB score for patients using their electronic medication list. It can also list the individual anticholinergic medications contributing to that score. Patients with high ACB score will be highlighted to healthcare staff including pharmacists, nurses, and doctors. In this project, we plan to understand how this tool can be used by clinicians in older persons wards to reduce the number of anticholinergic medications prescribed where appropriate. Our approach Working with doctors and pharmacists in one large hospital, we agreed how the tool should be used. First, pharmacists with check weekly using the digital tool how many patients have high ACB scores. Then they would highlight in patients' medical notes the list of medications with high anticholinergic effects using a sticker note. The doctor looking after the patient then sees the note which would prompt him/her to either stop the drug, reduce the dose or switch to a safer drug. We will test this intervention among 50 patients admitted to older people wards. We will collect information before and after receiving the intervention including number and type of medications prescribed, quality of life, and cognition. We will also talk to staff and patients to understand their views about the intervention, any challenges, and how to improve the process. Involving patients and public Two patient and public contributors have been actively involved in developing this research proposal. They represent an older person with comorbidity and polypharmacy and a carer, and both have lived experience of managing polypharmacy following hospital admission. They will continue to provide input on study procedures and materials and contribute to plans for sharing the findings. Sharing the study findings We will share the findings with public, health professionals, researchers and policymakers through plain English summaries, social media, policy briefing documents, scientific papers, conferences and other meetings.

Conditions

Older Adults (60 - 85 Years Old)

Outcome Measures

Primary Outcomes (4)

• The proportion of eligible patients and the feasibility of recruiting

  The proportion of eligible patients and the feasibility of recruiting

  3 months

• Follow up rates and response rates to questionnaires.

  • Follow up rates and response rates to questionnaires.

  3 months

• • Time needed for implementing the intervention (e.g. screening time using the TRISCRIBE tool) and resources

  • Time needed for implementing the intervention (e.g. screening time using the TRISCRIBE tool) and resources

  3 months

• Proportion of patients identified to have high ACB score who received the intervention

  • Proportion of patients identified to have high ACB score who received the intervention

  3 months

Secondary Outcomes (9)

• Activities of Daily living

  3 months

• Clinical Frailty Score

  3 months

• Geriatric Depression Scale

  3 months

• Mini-Mental State Examination

  3 months

• Sarcopenia

  3 months

Study Arms (1)

Patients will receive a collaborative deprescribing intervention

OTHER

Patients will receive a collaborative deprescribing intervention including: 1) pharmacist-led identification of patients using TRISCRIBE digital tool and highlighting anticholinergics medications on their clinical notes for targeted deprescribing, 2) doctor-led medication review to stop, reduce dose or switch to safer alternatives based on individual patient needs, and 3) highlighting and communicating medication changes to GP on discharge summaries.

Other: DART

Interventions

DART OTHER

Patients will receive a collaborative deprescribing intervention

Patients will receive a collaborative deprescribing intervention

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Eligible patients aged 65 years or more admitted to one of the five MOP wards, who have ACB score of 3 or more, and able to provide an informed consent.

You may not qualify if:

• Those who are expected to have a limited life expectancy, receiving palliative care will be excluded.

Sponsors & Collaborators

• University Hospital Southampton NHS Foundation Trust: lead

Study Sites (1)

School of Medicine

Southampton, United Kingdom

Location

Related Links

• NIHR ARC Wessex DART website

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 18, 2026
• First Posted: March 24, 2026
• Study Start: May 22, 2025
• Primary Completion: January 10, 2026
• Study Completion: January 10, 2026
• Last Updated: March 24, 2026

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)