RPD223 - Feasibility and Acceptability of a Patient-Centered Deprescribing Assessment in Community-Based Palliative Care

Key Message : In a community-based palliative care deprescribing program, patients reported better understanding of medications and fewer side effects. Beyond clinical care, they highlighted social support from the team as central, helping them feel seen, connected, and engaged, underscoring the importance of relational, patient-centered approaches in deprescribing.

Abstract: Background
Polypharmacy is prevalent among patients in community-based palliative care and contributes to adverse outcomes(1). The Patient-Centered Structured Deprescribing Assessment was developed to standardize a team-based deprescribing process that integrates social determinants of health screening within the MedStar Health Palliative Telehealth and Clinic Connecting to Home (PATCH) program.
Objective
To evaluate the implementation of a team-based deprescribing program in community-based palliative care and to explore patients’ experiences.
Methods
Quantitative data extracted from the medical record were used to describe patient demographics and deprescribing visits completion rates. Semi-structured interviews explored patient experiences with deprescribing and perceptions of the PATCH team.
Results
A total of 792 patients participated in the PATCH program over 18 months (mean age 67 years; 52% female; 66% Black). Patients engaged in an average of 17 encounters over 243 days prior to discharge. Primary palliative diagnoses included cancer (43%), cardiac conditions (39%), and other serious illnesses. Patients reported feeling physically and emotionally better after deprescribing, with increased energy, fewer medication side effects, and greater understanding of their medications. They expressed strong trust in the PATCH team and valued the coordinated work of pharmacists, clinicians, and chaplains. Many noted that the deprescribing process improved communication and active involvement in care decisions. The social support provided by the PATCH program was described as reducing isolation and helping patients feel connected to care and resources. One participant summarized it as “someone making sure I am taken care of and nothing is missed.”
Conclusions
The structured, team-based deprescribing process was feasible, successfully reached a diverse patient population, and was perceived by patients as supportive, informative, and caring. These findings highlight the acceptability of a structured, patient-centered deprescribing approach within a community-based palliative care program. These findings lay a foundation for evaluating the impact of deprescribing on healthcare utilization and patient experience outcomes.

References: 1. McNeill,, R., Hanger, HC., Chieng, J., & Chin, P. (2023). Polypharmacy in palliative care: Two deprescribing tools compared with a clinical review. Journal of Palliative Medicine. https://doi.org/10.1089/jpm.2020.0225