The United Hospital Fund recently adopted a new tool that successfully assisted five New York nursing homes in deprescribing frail, end-of-life residents.

The number of vulnerable residents taking 10 or more medications across the facilities decreased by 34% after UHF introduced the Screening Tool for Older Persons’ Prescriptions in Frail adults (STOPPFrail). Participating nursing homes were also able to improve the quality of life for the 136 eligible residents by reducing the average number of medications they were taking by 10%. 

Operators can use STOPPFrail to provide the best possible care for residents who are nearing the end of life by reducing polypharmacy, which can lead to the over-prescribing of potentially unnecessary and harmful medications and impact seniors’ well-being.

“Nursing homes must find ways to identify these individuals and support them,” Joan Guzik, director of quality and efficiency at UHF’s Quality Institute, said in a statement emailed to McKnight’s Long-Term Care News. “STOPPFrail is a relatively simple tool that can help providers do this, as the goal of care shifts from treating and preventing illness to maximizing comfort and quality of life.” 

STOPPFrail’s workflow was used to review residents’ current medications and compare them to the tool’s deprescribing guidance, with potential deprescribing opportunities then being identified.

To qualify, residents had to meet three criteria: have severe functional impairment, severe frailty and a life expectancy likely to be less than a year.

Of the 136 participants, 76% (103) were taking at least one high-risk medication. And of that group, 72% (74) had at least one medication discontinued or the dosage gradually lowered. 

Each facility was able to determine the approach that worked best for their residents, such as choosing to screen all residents in the facility versus a smaller group. Some also established additional workflows, like an Advanced Care Plan workflow, to coincide with STOPPFrail. 

UHF partnered with Hebrew Home at Riverdale, Jamaica Hospital Nursing Home, Mary Manning Walsh Nursing Home, the New Jewish Home, and NYC Health + Hospitals/Gouverneur, all of which it previously worked with on another of its deprescribing efforts.

Last year, the five facilities took part in an initiative that spurred an 8% decrease in the number of potentially harmful medications prescribed to nursing home residents.

That second annual, six-month-long test period also recorded a decline in the number of residents receiving 10 or more medications. 

Some of the medications targeted were antihistamines, antidepressants and opioids, which declined by 68%, 62% and 53%, respectively.