Objective To identify potentially inappropriate medications (PIMs) using deprescribing tools and to evaluate longitudinal changes in the number of PIMs and their associated costs between baseline (T₀) and follow-up (T F) among patients receiving outpatient palliative care (PC). Methods This retrospective longitudinal study reviewed electronic medical records of adult patients (≥18 years) who initiated follow-up in 2022 at an outpatient PC clinic of a Brazilian teaching hospital. Patients were monitored for up to 12 months. PIMs were identified using the STOPPFrail version 2 (v2) and OncPal criteria at baseline (T₀) and at the last outpatient consultation (T F). Differences in the number of PIMs and their associated costs between T₀ and T F were analysed using descriptive statistics and paired comparisons with the Wilcoxon signed-rank test. Results Among 42 patients included in the longitudinal analysis, STOPPFrail v2 identified a small but statistically significant increase in PIM exposure over time (median 3 (IQR 3–4) at T₀ vs 4 (IQR 3–5) at T F ; p=0. 041). Median PIM-related costs also increased, from US0. 06 (IQR 0. 03–0. 25) at T₀ to US0. 14 (IQR 0. 04–0. 26) at T F ; however, this difference was not statistically significant (p=0. 165). In contrast, according to the OncPal criteria, PIM exposure remained stable (median 4 (IQR 3–5) at both T₀ and T F ; p=0. 591). Likewise, PIM-related costs showed no significant change, increasing from US0. 05 (IQR 0. 01–0. 10) at T₀ to US0. 08 (IQR 0. 04–0. 14) at T F (p=0. 117). Conclusions PIM exposure remained high over time in outpatient PC, with minimal variation depending on the assessment tool used and no significant reduction in medication-related costs. These findings highlight the complexity of prescribing in this population and the need for new deprescribing strategies.
Oliveira et al. (Thu,) studied this question.