Table 4.

Outcome measures

Full name of assessment tool	Reasoning
DBI14	Assesses the cumulative effect of anticholinergic and sedative medicines in a quantitative score Increasing DBI has been associated with poorer physical function, falls, frailty, hospitalisation and mortality in studies of polypharmacy A change of 0.5 in score is clinically significant
InterRAI-LTCF29	Includes a wide array of cognitive performance, ADL using the interRAI Hierarchy ADL scale30 and health quality assessments The reliability of the interRAI suite of assessment instruments has been tested and has been shown that all items tested met or exceeded standard cut-offs for acceptable reliability and a substantial proportion of items showed excellent reliability.25 It is a versatile, viable way of recording health information from routine practice in a way that permits aggregation of accurate, reliable, valid data, safe for use in health services research and pragmatic studies where randomised controlled trials are impossible.26
EQ-5D-3L quality of life measure31	This measure will be used to monitor the participants' quality of life during the study and has been used in a number of interventional studies in this population. It allows for economic evaluation.
UKU-SERS32	As we aim to deprescribe anticholinergic and sedative medicines (ie, which include psychotropic medicines) and we expect our participants to be prescribed a large amount of these medicines inappropriately, it is pertinent to choose an adverse effect rating scale such as the UKU-SERS, which specifically reports on the unwanted adverse effects associated with the use of psychotropic medicines.

The rationale behind the use of these tools and assessments is summarised in table 4. Nurses will also be asked to monitor the appearance of specific ADWEs for each medicine to be deprescribed. Monitoring will be conducted for each individual and all ADWEs will be noted on the participant's MMP form.

ADL, activities of daily living; ADWE, adverse drug withdrawal effect; DBI, Drug Burden Index; EQ-5D-3L, EuroQoL 5-dimension 3-level; InterRAI-LTCF, InterRAI-Long Term Care Facilities; MMP, medication management plan; UKU-SERS, UKU-Side Effect Rating Scale.