To identify potentially inappropriate medications (PIMs) using deprescribing tools and to evaluate longitudinal changes in the number of PIMs and their associated costs between baseline (T₀) and follow-up (TF) among patients receiving outpatient palliative care (PC).
This retrospective longitudinal study reviewed electronic medical records of adult patients (≥18 years) who initiated follow-up in 2022 at an outpatient PC clinic of a Brazilian teaching hospital. Patients were monitored for up to 12 months. PIMs were identified using the STOPPFrail version 2 (v2) and OncPal criteria at baseline (T₀) and at the last outpatient consultation (TF). Differences in the number of PIMs and their associated costs between T₀ and TF were analysed using descriptive statistics and paired comparisons with the Wilcoxon signed-rank test.
Among 42 patients included in the longitudinal analysis, STOPPFrail v2 identified a small but statistically significant increase in PIM exposure over time (median 3 (IQR 3–4) at T₀ vs 4 (IQR 3–5) at TF; p=0.041). Median PIM-related costs also increased, from US$0.06 (IQR 0.03–0.25) at T₀ to US$0.14 (IQR 0.04–0.26) at TF; however, this difference was not statistically significant (p=0.165). In contrast, according to the OncPal criteria, PIM exposure remained stable (median 4 (IQR 3–5) at both T₀ and TF; p=0.591). Likewise, PIM-related costs showed no significant change, increasing from US$0.05 (IQR 0.01–0.10) at T₀ to US$0.08 (IQR 0.04–0.14) at TF (p=0.117).
PIM exposure remained high over time in outpatient PC, with minimal variation depending on the assessment tool used and no significant reduction in medication-related costs. These findings highlight the complexity of prescribing in this population and the need for new deprescribing strategies.