Deprescribing for Older Adults After Hospital Discharge in Home Health Care

Deprescribing for Older Adults After Hospital Discharge in Home Health Care - A Pilot Feasibility Study of the HomeMed Deprescribing Intervention

The purpose of this study is to examine the feasibility of providing a medication optimization program to improve patient health outcomes during the transition from hospital to home. This is because the period after hospital discharge is critical to long-term recovery, overall quality of life, and prevention of future hospitalizations.

Study Overview

• Status: Completed
• Conditions: Polypharmacy
• Intervention / Treatment: Behavioral: HomeMed

• Study Type: Interventional
• Enrollment (Actual): 5
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Rochester, New York, United States, 14642
      • University of Rochester Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No

Description

Patient Inclusion Criteria:

• 65 years of age and older
• currently hospitalized or having been hospitalized in the previous 2 weeks
• having a discharge disposition of home with a referral to receive HHC services from URMHC, or currently receiving HHC services from URMHC
• taking more than 10 regular medications daily
• having a primary care provider who is in the URMC system
• Ability to self-consent
• English-speaking

Patient Exclusion Criteria:

• end-of-life prognosis in the following 6 months
• currently receiving hospice care, end-of-life care, or palliative care
• conditions that impact the receipt of the intervention, such as severe cognitive impairment that interferes with the subject's ability to communicate with interventionists;
• substantial difficulties in hearing, vision, and verbal expression that disable the participant from communicating effectively while receiving the HomeMed intervention

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: All Participants

Behavioral: HomeMed; The HomeMed intervention is a multidisciplinary deprescribing intervention including home visits and team-based telehealth communication (optional). The components included in the HomeMed intervention include home medication review, medication education and provision of tools to assist the patients with medication administration, assessment of deprescribing targets by a trained geriatric clinical pharmacist, communication with the patient's treating primary care provider about deprescribing recommendation, deprescribing implementation (optional), and deprescribing monitoring (optional). Depending on the patient's treating primary care provider's decision on deprescribing and monitoring, the number of home visits ranges from a minimum of three to more with the entire duration of the intervention ranging from approximately 1 to 3 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
mean time spent on intervention		3 months
number of participants who complete a post intervention survey about feasibility		3 months
Percentage of participants undergoing deprescribing		3 months
Percentage of intervention adherence indicators checked		3 months
Percentage of patients who improve in ability to do things that are important before and after intervention		3 months
Total number of medications used per participant		3 months
Percentage of patients who report a reduction in medication burden	Medication burden will be reported by phone or survey.	3 months
Percentage of participants who report a reduction in medication side effect	Side effects will be collected by phone.	3 months

Collaborators and Investigators

• Sponsor: University of Rochester
• Collaborators: National Institute on Aging (NIA)

Study record dates

Study Major Dates

• Study Start (Actual): March 29, 2023
• Primary Completion (Actual): May 30, 2025
• Study Completion (Actual): May 30, 2025

Study Registration Dates

• First Submitted: November 17, 2022
• First Submitted That Met QC Criteria: November 17, 2022
• First Posted (Actual): November 29, 2022

Study Record Updates

• Last Update Posted (Actual): July 16, 2025
• Last Update Submitted That Met QC Criteria: July 10, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: STUDY00007846; R24AG064025 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No