A pilot study testing a medication algorithm to reduce polypharmacy

Background: Polypharmacy is common in the treatment of persons with severe mental illness, yet it is not an evidence-based practice. To address this, an attempt was made to reduce medications for patients already receiving polypharmacy during an episode of acute psychiatric hospitalization. Methods: A medication-reduction algorithm was developed , based on the best available evidence regarding indications for and efficacy of medications and principles of collaborative care. A feasibility pilot study was conducted using a matched case-control design for 12 patients treated with the algorithm and 12 patients treated as usual. Results: The intervention patients were discharged on significantly fewer medications than controls; symptom reduction and length of stay did not differ significantly. Conclusion: A collaborative approach to reducing polypharmacy may reverse the trend to add medications during hospitalization.