This study evaluated the effects of pharmacist-led multidisciplinary conferences on deprescribing and reducing anticholinergic risk in older inpatients, assessed in part using the Japanese Anticholinergic Risk Scale (JARS). In 2021, we retrospectively analyzed 130 older inpatients admitted to Tokyo Medical University Hospital who were prescribed six or more medications at admission. Patients were divided into a conference group (C group, n ＝ 75) and a non-conference group (nC group, n ＝ 55). The primary outcome was the proportion of patients achieving deprescribing, which was defined as discontinuation at discharge. Secondary outcomes included drug classes and reasons for deprescribing and changes in JARS. Deprescribing occurred in 65% in the nC group and 87% in the C group (p < 0.05). Frequently deprescribed drug classes included antihypertensives, laxatives, and antithrombotics. Reasons for deprescribing were dysphagia, symptom resolution, consideration of potential adverse drug events, and others. JARS reduction was observed in 20% in the nC group and 44% in the C group (p < 0.05). To adjust for potential confounders, multivariable logistic regression analysis was performed with outcomes of deprescribing and JARS reduction, conference implementation as the main independent variable, and age, sex, BMI, eGFR, length of stay, and history of stroke as covariates. Length of stay was significantly associated with deprescribing, while JARS reduction was significantly associated with both the C group and length of stay. Pharmacist-led conferences were independently associated with a reduction in anticholinergic burden. Length of stay was also associated with deprescribing.

Older adults are at higher risk of inappropriate dosing of renally excreted drugs owing to polypharmacy and age-related renal decline. In home care and long-term care facilities (LTCFs), renal function assessment is often limited, and prescriptions frequently rely on outdated laboratory data. Herein, we evaluated the utility of portable point-of-care testing (POCT) for onsite renal assessment to optimize drug dosing. Seventy-one participants were enrolled, including 46 home care patients and 25 LTCF residents. Potential overdosing was identified in four home care patients and in seven LTCF residents. Dose adjustments were implemented in all home care patients, whereas no changes were made for patients at LTCFs. Among the LTCF residents, prior venous creatinine values obtained 1-19 months earlier differed from the on-site POCT values by −0.44 to +0.40 mg/dL. POCT enabled timely assessment of renal function; however, its clinical impact may depend on the healthcare delivery system. In conclusion, POCT may support safer dosing of renally excreted drugs.