OBJECTIVES: Medication safety for elderly people is an ongoing challenge. Older people are often exposed to unnecessary or inappropriate medications – medicines with a high risk of harm. There is evidence that inappropriate medications are overprescribed, accounting for a significant proportion of avoidable adverse drug events, emergency department visits and hospitalizations. This study aims to present the protocol of a study to investigate the effectiveness and cost-effectiveness of a community pharmacist-general practitioner collaborative deprescribing intervention of potential inappropriate class of medicines, focusing proton-pump inhibitors, among the community dwelling elderly.

METHODS: The study is a 6-month multicentre, pragmatic, non-randomized controlled trial and will test the effect of a collaborative deprescribing intervention to reduce the use of inappropriate proton-pump inhibitors among 222 community-dwelling older adults compared to usual care. Patients will be recruited from community pharmacies in Portugal mainland. Participants in the experimental group will receive a multifaceted intervention (educational brochure delivery, consultation with the general practitioner, follow-up contact after medicines’ assessment) delivered in co-ordination by the pharmacist and the general practitioner. The primary outcome is the successful deprescription – discontinuation or decreased dose of the targeted medication at 6-month follow-up. Patient reported outcomes and intervention experiences, regarding the intervention, will also be assessed. For both groups (intervention and control), data will be collected from structured patient questionnaires, and dispensing pharmacies software. Additionally, for intervention characterization, the health professional’s intervention registry will be collected. An economic evaluation from the National Health Service perspective will be undertaken. A ISRCTN registry will be perform.

RESULTS: No results are available to date.

CONCLUSIONS: This trial will add evidence about the effectiveness and cost-effectiveness of a patient-centered approach to withdraw a commonly inappropriate class of medicines among older patients. Furthermore, it will provide evidence to help implementing future nationwide approaches for collaborative services in primary care.