Deprescribing within English care homes: guidance and recommendations from the STOPPING project

Background : Care home residents often experience polypharmacy. Deprescribing, or the reduction or stopping of prescription medicines that may no longer be providing benefit, is generally safe but it is unknown how to make it work well in care homes. Aim : Develop recommendations and guidance for implementing a deprescribing approach that is feasible and suitable within care homes. Methods : The findings from two qualitative work packages of the STOPPING project were synthesised to inform guidance for deprescribing within care homes. In total, 42 interviews were conducted with 36 participants from 15 different care homes. A framework analysis approach, informed by an implementation science framework, was used to analyse and combine data from both work packages. Results : Key considerations for deprescribing in care homes are as follows: engaging multiple individuals and organisations; recognising their various roles, responsibilities, expertise, and beliefs; information access and sharing; and active monitoring of the impact of deprescribing. The key factor is the quality of local working relationships. Discussion : Communication and collaboration between care homes and healthcare professionals are essential to ensure deprescribing is done well. The guidance suggests several courses of action and resources for how to improve future deprescribing in care homes.