Forget‐Me‐Not: Evaluation of a Post Hospital Antipsychotic Deprescribing Intervention in Dementia and Delirium
4 affiliations
- 1Eastern Health Institute Melbourne Victoria Australia
- 2Eastern Health Clinical School Monash University Melbourne Victoria Australia
- 3Eastern Health Pharmacy Department Melbourne Victoria Australia
- 4Eastern Health General Medicine Program Melbourne Victoria Australia
Abstract
Objective: To evaluate the impact of a joint hospital pharmacist and medical physician deprescribing intervention on antipsychotic cessation and/or dose reduction 12 weeks post hospital discharge.
Methods: This prospective cohort study was conducted at a Victorian metropolitan hospital network. Patients discharged from General Medicine, with delirium or dementia and prescribed at least one antipsychotic were eligible. The control group (July to November 2021) received written information about antipsychotic use in dementia and/or delirium. The intervention group (May to December 2022) received the same written information and a pharmacist/physician antipsychotic review after hospital discharge. Deprescribing recommendations were communicated to General Practitioners (GPs) for consideration and action. Antipsychotic prescription was recorded at 12 weeks post‐discharge.
Results: Sixty‐two per cent of control group patients (n = 81) and 75% of intervention group patients (n = 77) were alive at the 12‐week follow‐up. For surviving patients, there was no difference in complete antipsychotic cessation between groups (32% control vs. 17% intervention, p = 0.07); however, the control group had greater total dose reduction (42% vs. 17%, p = 0.005).
Conclusion: The intervention did not reduce antipsychotic prescription at 12 weeks, compared to standard care. Rather, on the outcome of antipsychotic dose reduction, standard care was better. These were unexpected findings. Differences in clinical diagnosis and specific antipsychotic prescribed may be confounding factors, warranting further analysis. A negative outcome is important to report as new practices should have robust evidence before consideration for wider implementation.
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BibTeX
@article{ngo2026forgetmenot,
title = {{Forget‐Me‐Not: Evaluation of a Post Hospital Antipsychotic Deprescribing Intervention in Dementia and Delirium}},
author = {Cathy Ngo and Stephanie Gibson and Hiba Ali and Mahesan Anpalahan and Ken Teo and Rohith Valsalan and Paul Wembridge and Emily Schembri and Gary Yip},
journal = {Australasian Journal on Ageing},
year = {2026},
month = nov,
doi = {10.1111/ajag.70245},
url = {https://doi.org/10.1111/ajag.70245},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Forget‐Me‐Not: Evaluation of a Post Hospital Antipsychotic Deprescribing Intervention in Dementia and Delirium
AU - Cathy Ngo
AU - Stephanie Gibson
AU - Hiba Ali
AU - Mahesan Anpalahan
AU - Ken Teo
AU - Rohith Valsalan
AU - Paul Wembridge
AU - Emily Schembri
AU - Gary Yip
PY - 2026
DA - 2026/11/03
JO - Australasian Journal on Ageing
DO - 10.1111/ajag.70245
UR - https://doi.org/10.1111/ajag.70245
AB - Objective: To evaluate the impact of a joint hospital pharmacist and medical physician deprescribing intervention on antipsychotic cessation and/or dose reduction 12 weeks post hospital discharge. Methods: This prospective cohort study was conducted at a Victorian metropolitan hospital network. Patients discharged from General Medicine, with delirium or dementia and prescribed at least one antipsychotic were eligible. The control group (July to November 2021) received written information about antipsychotic use in dementia and/or delirium. The intervention group (May to December 2022) received the same written information and a pharmacist/physician antipsychotic review after hospital discharge. Deprescribing recommendations were communicated to General Practitioners (GPs) for consideration and action. Antipsychotic prescription was recorded at 12 weeks post‐discharge. Results: Sixty‐two per cent of control group patients (n = 81) and 75% of intervention group patients (n = 77) were alive at the 12‐week follow‐up. For surviving patients, there was no difference in complete antipsychotic cessation between groups (32% control vs. 17% intervention, p = 0.07); however, the control group had greater total dose reduction (42% vs. 17%, p = 0.005). Conclusion: The intervention did not reduce antipsychotic prescription at 12 weeks, compared to standard care. Rather, on the outcome of antipsychotic dose reduction, standard care was better. These were unexpected findings. Differences in clinical diagnosis and specific antipsychotic prescribed may be confounding factors, warranting further analysis. A negative outcome is important to report as new practices should have robust evidence before consideration for wider implementation.
SN - 1440-6381
SN - 1741-6612
ER -