We were awarded funding from the National Institute for Health Research (NIHR) to develop a way of reducing and stopping some medicines for older people living in care homes.
Background
Older people with multiple health problems often take many medicines. However, some medicines may not have benefits for those taking them and cause more harm than good, especially as we get older or more ill. Deprescribing means reducing or stopping some prescription medicines which may no longer be providing benefit. Previous research has found that deprescribing is generally safe, but we still don't really know how to make it work in real-life settings, like care homes. Implementing deprescribing in care homes can be challenging due to the different concerns of residents, staff, doctors, family members and carers as well as the differences in care home structures.
Project aims
Our primary research question was, 'How can an approach to reducing and stopping medicines in care homes be developed with the relevant people involved, taking account of the different circumstances in this setting?'
The overall aim of the study was to develop an approach to reducing and stopping some medicines that work in care homes. We:
- Identified what helps and what hinders the reduction and stopping of some medicines in different types of care home providers
- Identified whether current approaches were acceptable, practicable and suitable
- Created guidance for developing a new way of reducing and stopping some medicine for care homes
Project activity
Work Stream One
We used different research methods to identify the key barriers, facilitators and contextual factors which affected reducing and stopping medicines. We interviewed residents and their family members/friends, held focus groups with staff and healthcare professionals and made observations at care homes.
Work Stream Two
We evaluated the acceptability, feasibility, and suitability of current approaches to reducing or stopping medicines by interviewing healthcare professionals and care home staff about their views of different approaches.
Work Stream Three
We brought together the findings from the interviews, focus group discussions and observations in the other work streams. We combined the findings with the help of an established method to produce an approach to reducing and stopping medicines suitable for care homes.
Our primary output was guidance for an approach to reducing and stopping medicines. This was developed and used for future intervention development for care homes.
Findings and learnings from the STOPPING study were presented on 23 June at an event exploring how the implementation of deprescribing in care homes could enable best practice and resident care.
Papers and resources
Who was involved?
Principal Investigator: Dr Krystal Warmoth (PI), University of Hertfordshire
- Professor Ken Stein, University of Exeter
- Dr Emma Cockcroft, University of Exeter
- Dr Jo Day, University of Exeter
- Julia Heneker, Somerset Care Limited
- George Coxon, Pottles Court and Summercourt Care Homes
- Dr Lucy Pollock, Somerset NHS Foundation Trust
- Bridget Walton, Royal Devon & Exeter NHS Foundation Trust
Contact us
Krystal Warmoth, University of Hertfordshire (k.warmoth@herts.ac.uk)
