Large, ongoing hospital deprescribing trial in England
Dear Editor,
I read with interest the article about deprescribing in older adults with polypharmacy. I am the patient and public lead of CHARMER which is a 5-year NIHR funded deprescribing research project that commenced in September 2020. Deprescribing is therefore a patient safety issue that I am passionate about helping to address. I notice that the article highlights the dominance of deprescribing research in the primary care setting. I am delighted to advise that CHARMER is a deprescribing trial involving 24 hospitals,120 doctors and pharmacists, and 22,000 older patients. The CHARMER definitive trial (ISRCTN13248281, registered 21/07/2023) commenced in February 2024.
CHARMER is a practitioner behaviour change intervention (1) developed from the theory and evidence-based Hospital Deprescribing Implementation Framework (2). The CHARMER project aims to increase opportunities and recognition for geriatricians and pharmacists proactively stopping medicines prescribed for older people that are more likely to cause harm than benefit. Less than 1% of patients have a medicine proactively stopped on hospital admission (3). The CHARMER project aims to address this. The primary outcome measure for the trial is a 90-day hospital readmission rate and the other reported outcomes are in accordance with the core outcome set for hospital deprescribing trials (4).
As a £2.4M publicly funded project, I am keen to ensure that we raise awareness of the work in order to support any necessary change in policy and practice arising from CHARMER’s findings.
Katherine Murphy, Patient and Public Lead on behalf of the CHARMER team
charmerstudy.org
@CHARMER_Study
References:
1. Scott, S., Atkins, B., Kellar, I., Taylor, J., Keevil, V., Alldred, D.P., Murphy, K., Patel, M., Witham, M.D., Wright, D. and Bhattacharya, D. (2023). Co-design of a behaviour change intervention to equip geriatricians and pharmacists to proactively deprescribe medicines that are no longer needed or are risky to continue in hospital. Research in social and administrative pharmacy, 19(5), pp.707–716.
2. Scott, S., Twigg, M.J., Clark, A., Farrow, C., May, H., Patel, M., Taylor, J., Wright, D.J. and Bhattacharya, D. (2019). Development of a hospital deprescribing implementation framework: A focus group study with geriatricians and pharmacists. Age and Ageing, 49(1), pp.102–110.
3. Scott, S., Clark, A., Farrow, C., May, H., Patel, M., Twigg, M.J., Wright, D.J. and Bhattacharya, D. (2018). Deprescribing admission medication at a UK teaching hospital; a report on quantity and nature of activity. International Journal of Clinical Pharmacy, 40(5), pp.991–996.
4. Martin-Kerry, J., Taylor, J., Scott, S., Patel, M., Wright, D., Clark, A., Turner, D., Alldred, D.P., Murphy, K., Keevil, V., Witham, M.D., Kellar, I. and Bhattacharya, D. (2022). Developing a core outcome set for hospital deprescribing trials for older people under the care of a geriatrician. Age and Ageing. doi:https://doi.org/10.1093/ageing/afac241.
Rapid Response:
Large, ongoing hospital deprescribing trial in England
Dear Editor,
I read with interest the article about deprescribing in older adults with polypharmacy. I am the patient and public lead of CHARMER which is a 5-year NIHR funded deprescribing research project that commenced in September 2020. Deprescribing is therefore a patient safety issue that I am passionate about helping to address. I notice that the article highlights the dominance of deprescribing research in the primary care setting. I am delighted to advise that CHARMER is a deprescribing trial involving 24 hospitals,120 doctors and pharmacists, and 22,000 older patients. The CHARMER definitive trial (ISRCTN13248281, registered 21/07/2023) commenced in February 2024.
CHARMER is a practitioner behaviour change intervention (1) developed from the theory and evidence-based Hospital Deprescribing Implementation Framework (2). The CHARMER project aims to increase opportunities and recognition for geriatricians and pharmacists proactively stopping medicines prescribed for older people that are more likely to cause harm than benefit. Less than 1% of patients have a medicine proactively stopped on hospital admission (3). The CHARMER project aims to address this. The primary outcome measure for the trial is a 90-day hospital readmission rate and the other reported outcomes are in accordance with the core outcome set for hospital deprescribing trials (4).
As a £2.4M publicly funded project, I am keen to ensure that we raise awareness of the work in order to support any necessary change in policy and practice arising from CHARMER’s findings.
Katherine Murphy, Patient and Public Lead on behalf of the CHARMER team
charmerstudy.org
@CHARMER_Study
References:
1. Scott, S., Atkins, B., Kellar, I., Taylor, J., Keevil, V., Alldred, D.P., Murphy, K., Patel, M., Witham, M.D., Wright, D. and Bhattacharya, D. (2023). Co-design of a behaviour change intervention to equip geriatricians and pharmacists to proactively deprescribe medicines that are no longer needed or are risky to continue in hospital. Research in social and administrative pharmacy, 19(5), pp.707–716.
2. Scott, S., Twigg, M.J., Clark, A., Farrow, C., May, H., Patel, M., Taylor, J., Wright, D.J. and Bhattacharya, D. (2019). Development of a hospital deprescribing implementation framework: A focus group study with geriatricians and pharmacists. Age and Ageing, 49(1), pp.102–110.
3. Scott, S., Clark, A., Farrow, C., May, H., Patel, M., Twigg, M.J., Wright, D.J. and Bhattacharya, D. (2018). Deprescribing admission medication at a UK teaching hospital; a report on quantity and nature of activity. International Journal of Clinical Pharmacy, 40(5), pp.991–996.
4. Martin-Kerry, J., Taylor, J., Scott, S., Patel, M., Wright, D., Clark, A., Turner, D., Alldred, D.P., Murphy, K., Keevil, V., Witham, M.D., Kellar, I. and Bhattacharya, D. (2022). Developing a core outcome set for hospital deprescribing trials for older people under the care of a geriatrician. Age and Ageing. doi:https://doi.org/10.1093/ageing/afac241.
Competing interests: No competing interests