Table 5.
Details of all 440 recommendations made by pharmacist for high-risk medicines to be stopped or amended
| High-risk medicine or combination | Accepted recommendation | Percentage accepted | Rejected recommendation | Percentage rejected | |
|---|---|---|---|---|---|
| Deprescribed | Amended | ||||
| Aged >60 years plus anticholinergic | 9 | 5 | 60.9 | 9 | 39.1 |
| Aged >60 years plus antihypertensive and diuretic | 2 | 0 | 28.6 | 5 | 71.4 |
| Aged >60 years plus antipsychotic | 4 | 1 | 45.5 | 6 | 54.5 |
| Aged >60 years plus antipsychotic and hypnotic | 1 | 0 | 33.3 | 2 | 66.7 |
| Aged >60 years plus antipsychotic and tricyclic antidepressant and anticholinergic | 0 | 0 | 0.0 | 1 | 100.0 |
| Aged >60 years plus antipsychotic and benzodiazepine | 0 | 0 | 0.0 | 1 | 100.0 |
| Aged >60 years plus benzodiazepine and hypnotic | 0 | 2 | 20.0 | 8 | 80.0 |
| Aged >60 years plus benzodiazepine and tricyclic antidepressant | 0 | 0 | 0.0 | 3 | 100.0 |
| Aged >60 years plus benzodiazepine | 1 | 1 | 11.8 | 15 | 88.2 |
| Aged >60 years plus digoxin | 0 | 8 | 57.1 | 6 | 42.9 |
| Aged >60 years plus diuretic and other antihypertensives | 0 | 2 | 33.3 | 4 | 66.7 |
| Aged >60 years plus hypnotic | 4 | 18 | 43.1 | 29 | 56.9 |
| Aged >60 years plus hypnotic and sedating antihistamine | 0 | 0 | 0.0 | 2 | 100.0 |
| Aged >60 years plus hypnotic and tricyclic antidepressant | 1 | 1 | 40.0 | 3 | 60.0 |
| Aged >60 years plus sedating antihistamine | 1 | 0 | 33.3 | 2 | 66.7 |
| Aged >60 years plus tricyclic antidepressant | 11 | 16 | 43.5 | 35 | 56.5 |
| Aged >60 years plus tricyclic antidepressant and benzodiazepine | 0 | 0 | 0.0 | 2 | 100.0 |
| Aged >60 years plus tricyclic antidepressant and sedating antihistamine | 1 | 0 | 33.3 | 2 | 66.7 |
| Heart failure plus glitazone | 1 | 0 | 100.0 | 0 | 0.0 |
| Heart failure plus NSAID | 1 | 0 | 100.0 | 0 | 0.0 |
| Heart failure plus tricyclic antidepressant | 5 | 1 | 60.0 | 4 | 40.0 |
| Triple whammy combination (ACE/ARB + NSAID + diuretic) | 55 | 5 | 56.1 | 47 | 43.9 |
| NSAID plus aged >75 years and no gastro-protection | 3 | 15 | 75.0 | 6 | 25.0 |
| NSAID plus aspirin | 1 | 0 | 100.0 | 0 | 0.0 |
| NSAID plus eGFR <60 mL/min | 11 | 0 | 42.3 | 15 | 57.7 |
| NSAID plus heart failure | 2 | 1 | 60.0 | 2 | 40.0 |
| NSAID plus warfarin | 2 | 0 | 33.3 | 4 | 66.7 |
| Warfarin plus another antiplatelet | 10 | 1 | 68.8 | 5 | 31.3 |
| Warfarin plus macrolide | 0 | 1 | 100.0 | 0 | 0.0 |
| Other | 2 | 8 | 55.6 | 8 | 44.4 |
| Total | 128 | 86 | 48.6 | 226 | 51.4 |
ACE inhibitor angiotensin converting enzyme inhibitor, ARB angiotensin-II receptor blocker, eGFR estimated glomerular filtration rate, NSAID non-steroidal anti-inflammatory drug, PPI proton pump inhibitor