Addressing Polypharmacy: Implementing the Medication Appropriateness Index Clinical Tool to Increase Deprescribing by Healthcare Providers

Background: Polypharmacy is a national and local issue of concern within healthcare. Deprescribing medications has been identified as a plausible solution for patients experiencing polypharmacy. However, many healthcare providers are unaware of the practice of deprescribing and, if aware, may not be implementing clinical tools for deprescribing effectively. The family medicine clinical site supplies an opportunity for healthcare providers to utilize an evidence-based clinical tool to review medications, identify if inappropriate, and deprescribe if indicated. Purpose: The purposes of the Doctor of Nursing Practice (DNP) project were to increase deprescribing activity among prescribing healthcare providers and to increase prescribing healthcare providers’ awareness and adherence to incorporating evidence-based clinical guidelines for adults aged 62 years and older experiencing polypharmacy. Methods: This quality assurance project involved educational sessions provided to prescribing healthcare providers educating them how, when, and why to use the Medication Appropriateness Index (MAI) clinical tool supplemented with handouts and clinical scenarios. Results: Key results included statistically significant implications of deprescribing activity with utilization of the MAI clinical tool (p=0.0003). Numerical increases were observed as deprescribing activity increased. Notably, the average number of medications deprescribed was 1.85 medications. Conclusion: This project underscored the importance of utilizing an evidence-based clinical tool like the MAI clinical tool to increase the awareness of healthcare providers regarding polypharmacy and increase the occurrence of deprescribing activity