STOPPFrail Deprescribing Framework — SCE Palliative Medicine MCQ

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ModerateNon-Malignant Palliative CareSTOPPFrail Deprescribing FrameworkSCE Palliative Medicine

An 85‑year‑old woman with advanced frailty and multi‑morbidity is reviewed by the palliative care team. She is on 14 regular medications. What deprescribing framework should be applied?

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Correct answer: B — Systematic medication review using a framework such as STOPPFrail — identifying medications that are no longer providing net benefit given the patient's prognosis and goals

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · C = shown as D

STOPPFrail is a validated tool specifically designed for older adults with frailty and limited life expectancy to guide deprescribing in palliative contexts. It has high inter-rater reliability and does not compromise clinical outcomes (e.g., quality of life, mortality) while reducing inappropriate polypharmacy ([medicinesresources.nhs.uk](https://www.medicinesresources.nhs.uk/en/Medicines-Awareness/Primary-Research/Randomised-controlled-trials/Deprescribing-in-Older-People-Approaching-End-of-Life-A-Randomized-Controlled-Trial-Using-STOPPFrail-Criteria/?utm_source=openai)). STOPPFrail has been utilised within pharmacist-led interventions in the UK to successfully reduce potentially inappropriate medications in frail elderly populations ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/40863706/?utm_source=openai)). Option B ignores the risks of continued polypharmacy; C is unsafe without individual assessment; D contradicts evidence demonstrating deprescribing safety; and E introduces an irrelevant cost-centric and unethical approach.

Reference: NHS UKMi summary of an RCT: Deprescribing in Older People Approaching End of Life using STOPPFrail Criteria (2026) and Pharmacist‑Led Interventions using STOPPFrail in the UK (2025), https://www.medicinesresources.nhs.uk/en/Medicines-Awareness/Primary-Research/Randomised-controlled-trials/Deprescribing-in-Older-People-Approaching-End-of-Life-A-Randomized-Controlled-Trial-Using-STOPPFrail-Criteria/