Systematic Termination of Pharmaceutical Agents Trial (STOPAT): a pilot randomised trial of stopping drug therapy

INTERVENTION: Gradual withdrawal of one target medication selected from a defined list of Target Drugs (antihypertensive therapy, anti‐anginal therapy, diuretics, non‐steroidal anti‐inflammatory drugs and COX‐2 inhibitors). Dose reductions are made at two weekly intervals by general practitioner if participant remains clinically stable, until target drug has been ceased for two weeks. CONDITION: Polypharmacy PRIMARY OUTCOME: Proportion of intervention participants in which successful medication withdrawal could be achieved (defined by patient self report) SECONDARY OUTCOME: cognitive function: mini‐mental state examination [MMSE] Medication adherence: Morisky medication adherence scale Quality of life: SF‐36 and EQ5D visual analogue scale sleep quality: Pittsburgh Sleep Quality Index [PSQI] INCLUSION CRITERIA: i) participant taking at least one drug included in the Target Drug List (antihypertensive therapy, anti‐anginal therapy, diuretics, non‐steroidal anti‐inflammatory drugs and COX‐2 inhibitors); ii) participant has stable chronic disease with respect to the medication targeted for withdrawal iii) patient reports at least one negative symptom ascribable to the drug therapy (effects specific to drug class, or possible adverse effects such as falls, confusion, malaise and nausea), or the patient is taking more than 5 drugs concurrently iv) treating physicians concur with randomisation.