# A Randomized Controlled Trial to Deprescribe for Older Patients with Polypharmacy Transferred from the Hospital to Skilled Nursing Facilities

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2020 · $509,942

## Abstract

Project Summary
 The proposed randomized, controlled trial will evaluate the effects of an intervention to reduce
exposure to medications among hospitalized older adults discharged to skilled nursing facilities (SNFs). This
study will be conducted in one university-affiliated hospital and 14 area SNFs to enroll approximately 1,300
total participants across five project years. Patients discharged to SNF represent the largest segment of
Medicare beneficiaries discharged to post-acute care services and are a particularly high risk group for loss of
independence and other poor clinical outcomes. This investigative team recently completed a Centers for
Medicare and Medicaid Services (CMS) Innovation Award, which provides strong preliminary data related to
the prevalence of polypharmacy and the relationship between polypharmacy and geriatric syndromes (e.g.,
medications associated with falls) in this patient population. Based on these data, we developed a structured
deprescribing intervention protocol (“Shed-Meds”) coupled with standardized screening assessments for eight
geriatric syndromes to be implemented in the hospital and continued during the SNF stay. The goal of the
intervention is to safely deprescribe medications, as defined by dose reductions and stopped medications,
based on a combination of clinical criteria and patient preferences. We have pilot-tested our patient-centered
intervention in preparation for this proposal with promising results. The proposed trial will evaluate the effects
of this intervention on medication exposure, medication adherence, geriatric syndromes, and health status
across the care transitions from hospital to SNF to home to include a 90-day follow-up period after SNF
discharge. Our overarching hypothesis is that reducing medications for older patients across the continuum of
care will favorably impact geriatric syndromes.

## Key facts

- **NIH application ID:** 9936351
- **Project number:** 5R01AG053264-06
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** SANDRA F SIMMONS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $509,942
- **Award type:** 5
- **Project period:** 2016-09-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9936351

## Citation

> US National Institutes of Health, RePORTER application 9936351, A Randomized Controlled Trial to Deprescribe for Older Patients with Polypharmacy Transferred from the Hospital to Skilled Nursing Facilities (5R01AG053264-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9936351. Licensed CC0.

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