[AVBC 2025] NUH Deprescribing and Medication Optimization Initiative
Care Process & Redesign
Appropriate & Value-based Care Conference
National University Health System
3 December 2025
To reduce potentially inappropriate polypharmacy by embedding deprescribing practices into inpatient care delivery. Embedding deprescribing practices during hospitalisation, supported by multidisciplinary collaboration, system-level tools, and.
Year Submitted: 2025
Published Date: 03 December 2025
Tags: Care Process ＆ Redesign, Productivity, Cost Saving, Quality Improvement, Workflow Redesign, Value Based Care, Adherence Rate, Safe Care
About this Content
Aims
To reduce potentially inappropriate polypharmacy by embedding deprescribing practices into inpatient care delivery.
Background
Polypharmacy is identified as one of the strongest predictors of adverse drug events (ADE) especially among older adults. Hospitalisation offers an opportune window for medication review and optimization to better align therapy with patients' goals of care.
Methods
Identify Target Populations: Focus on severely frail patients, System-generated report for patient identification, Screen for inappropriate polypharmacy. Stakeholder Education: Deprescribing bulletins for pharmacist-led interventions, Target drug classes, Teaching sessions to junior doctors. System-Level Enablers: Electronic Medical Record enhancements, Visibility dashboard, Data-informed quality improvement monitoring.
Results
Since implementation, a sustained reduction in medication burden among patients discharged from the Department of Medicine was observed. This translates to patient cost savings and potentially lower risk of ADE.
Conclusion
Embedding deprescribing practices during hospitalisation, supported by multidisciplinary collaboration, system-level tools, and real-time monitoring, advances value-based care by minimizing low-value prescribing, improving medication safety and reducing unnecessary healthcare costs.
Lessons Learnt
Challenges encountered during implementation are discussed.
Keywords
Polypharmacy, Deprescribing, Medication, Optimization, Hospitalisation, ADE, Cost Savings, Quality Improvement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Hospital, National University Health System |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Pharmacy |
Applicable Specialty or Discipline | Pharmacology |
Project Lead(s) | He Jiang |
Project Member(s) | Sing Nee Chong |
Connect with this contributor!
He Jiang - he_jiang@nuhs.edu.sg
Project Attachment
486_NUH_AVBC_2025_NUH_Deprescribing_and_Medication_Optimization_Initiative.pdf