Aims: Multidisciplinary community interface models such as GEMITH may help address common barriers to deprescribing, yet evidence from this setting is limited. This study explored deprescribing practices within a GEMITH service, including medications targeted, post-discharge maintenance, and consumer perspectives.
Methods: This single-centre ambispective cohort study included community-dwelling older adults discharged from a metropolitan Australian GEMITH service to their general practitioner between November 2024 and March 2025. Deprescribing activity was extracted retrospectively from electronic medical records. Patients with one or more medications deprescribed at GEMITH discharge were eligible for prospective telephone follow-up at approximately three months. Medication counts, pill burden and Drug Burden Index (DBI) were analysed descriptively, with paired comparisons where appropriate. Consumer feedback was analysed via inductive thematic analysis.
Results: Seventy-eight patients were included (mean age 81±7 years; 53% female), of whom 68% (n=53) had medications deprescribed during the GEMITH episode of care. A total of 157 medications were deprescribed, most commonly vitamin/mineral supplements (26%), medications contributing to DBI (25%), and antihypertensives (10%). Among patients exposed to anticholinergic or sedative medications, a reduction in DBI was observed (p = .048). Forty-two patients (79%) completed post-discharge follow-up at a mean of 109±19 days, with 87% of medications remaining deprescribed. Participants reported high satisfaction with GEMITH deprescribing, with maintenance challenges primarily related to access to follow-up care and psychotropic medication discontinuation.
Conclusions: Deprescribing was frequently implemented by GEMITH and largely maintained after discharge, including high-risk medications, highlighting the value of geriatrician-led, multidisciplinary home-based care for medication optimisation in older adults.