Geriatric Psychotropic Stewardship Team to de-escalate inappropriate psychotropic medications in general medicine inpatients: An evaluation

Objectives: To assess the feasibility and effectiveness of a Geriatric Psychotropic Stewardship Team (GPST) and to achieve inpatient de-escalation of inappropriate psychotropic medications in patients aged over 65 years on a general medicine ward. Methods: A multidisciplinary GPST conducted twice-weekly rounds on general medicine inpatients known to be taking psychotropic medications. A consensus recommendation was generated, with subsequent treating team action recorded. Results: A total of 125 patients taking 180 psychotropic medications were identified for GPST review. Of these, 32 medications (18%) had been ceased by the treating team prior to GPST review. Adoption of GPST recommendations at 24 hours and at discharge occurred for 85 medications (57%) and 79 medications (53%), respectively. Conclusions: This study demonstrates the feasibility of a structured multidisciplinary approach in the de-escalation of inappropriate psychotropic medications in older hospital patients on a general medicine ward. Further studies are required to assess scalability and long-term clinical outcomes.