Withdrawing someone’s prescribed drugs to reduce their likelihood of experiencing side effects is called ‘deprescribing’. Th OPTIMISE2 trial will establish whether deprescribing common drugs that lower blood pressure is safe in older people. We will answer:
1. What is the effect of deprescribing blood pressure lowering drugs on hospital admissions and death?
2. Does deprescribing improve quality of life and save money for the NHS?
Background – More than one in three adults aged 75+ years are prescribed five or more drugs to treat their long-term conditions. People who take lots of drugs are more likely to end up with reduced independence and quality of life as they get older. They are also more likely to end up in hospital due to drug side effects. One solution is to stop or ‘deprescribe’ drugs which no longer provide benefit or could be harmful. The most prescribed drugs in older people are those used to lower blood pressure. These drugs reduce the risk of a stroke and heart attack. However, in some frail older people, they might also be harmful, causing kidney problems and fainting (leading to falls).
Building on previous research, we will carry out a trial with 3,014 participants. We will follow participants up for 1 year. Participants will be aged 75 years or older and taking blood pressure lowering drugs, but not have raised blood pressure readings. We will focus on those who are frail and/or with a higher risk of falls or kidney problems. The trial will examine whether deprescribing is safe in this group.
