Systematic Termination of Pharmaceutical Agents Trial (STOPAT)
The STOPAT (Systematic termination of pharmaceutical agents trial) is a new pilot randomised trial of medication withdrawal being commenced at Royal Perth Hospital.
Many doctors are concerned that their patients are taking therapy which may be ineffective, no longer required, producing side effects or having a detrimental effect on quality of life. However it is sometimes unclear whether withdrawal of these medications is safe. Many patients are also aware that therapy with several drugs simultaneously entails hazards related to drug interactions and side effects. In support of this point of view, up to 25% of all acute medical admissions to hospital are due to a clinical problem related to drug treatment.
Analysis of individual patients often reveals that some drugs are either unnecessary, or at least thought to be so in the opinion of the supervising doctor, either because the indication for them no longer exists or because they were injudiciously prescribed in the first place. Though clinical experience suggests that withdrawing these drugs may benefit individual patients, this has never been formally demonstrated. It has been shown that withdrawal of some drugs can alleviate a tendency to fall in elderly patients, and there is evidence that antihypertensive medication may be "down-titrated" (i.e. the dose may be reduced) without loss of antihypertensive effect.
The STOPAT pilot trial will involve tapering or withdrawal of target drugs. Follow-up will measure relevant physiological indices of well-being and quality of life.
Eligible volunteers will be aged ≥ 50 years and taking blood pressure, heart, fluid or pain killing medicine which they are concerned may be unnecessary. With the volunteer's permission the study staff will seek agreement from the volunteer's general practitioner prior to the volunteer entering the study. Volunteers entered into the study will be regularly followed up.
The trial is being run by Clinical Pharmacologists Prof Alasdair Millar, Dr Christopher Beer and Dr PK Loh working with Clinical Pharmacist Mr Yan Ghee Peng.
People interested in receiving further information about the trial can contact Ms Rhana Arnold on 9224 1338.
Further information
Additional information on the trial is available below.
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