Impact of Pharmacist-Led Deprescribing on Inappropriate Rapid-Acting Insulin Use Among Admitted Older Adults

This article describes a pharmacist-led deprescribing initiative to reduce the incidence of inappropriate rapid-acting insulin use among admitted older adults at an acute care community hospital. Inappropriate use was defined as at least one episode of severe hypoglycemia (blood glucose < 40 mg/dL) within 24 hours of insulin lispro administration, two or more episodes of hypoglycemia (blood glucose < 70 but > 40 mg/dL) within 24 hours of insulin lispro administration, or five or more held administrations of insulin lispro because of euglycemia in a 48-hour period. The initiative led to a 66% observed relative reduction of inappropriate rapid-acting insulin use over 7 months.