Using IMPACT tool to support deprescribing interventions in care homes (2025)

Dengie and South Woodham Ferrers Primary Care Network

Project summary

Care home residents are often frail and commonly experience polypharmacy, placing them at an increased risk of medication-related harm. Several tools exist to support the medication review process and reduce avoidable adverse drug events.
This Quality Improvement (QI) project evaluated the implementation of the IMPACT tool (version 4.1) in enhancing deprescribing interventions during Structured Medication Reviews (SMRs) for care home residents aged 65 or older who were prescribed eight or more medications.
Eligible residents across eight care homes within the Primary Care Network (PCN) were identified using SystemOne clinical searches, applying the inclusion criteria of age ≥65 and polypharmacy (≥8 medications). SMRs were conducted by a PCN clinical pharmacist, and medication-related interventions were audited over periods before and after the introduction of the IMPACT tool.
After the Introduction of IMPACT to support SMRs the average number of medication interventions increased from 1.3 to 1.4 per SMR; the number of deprescribing interventions increased from 0.5 to 0.7 per SMR and the average Anticholinergic Burden (ACB) score decreased by 0.2.