Montelukast deprescribing in outpatient specialty clinics: A single center cross-sectional study.

Objective: To identify and evaluate montelukast deprescribing in outpatient specialty clinics.
Methods: This was a single-center, retrospective, cross-sectional study conducted at an academic health system in the southern US including 21 specialty clinics. Subjects included adults ≥18 years with an active prescription for montelukast who attended at least one appointment in pulmonology, otolaryngology, or neurology outpatient specialty clinics between January 1, 2021 to December 31, 2022. Patients <18 years and those with diagnoses of uncontrolled asthma or allergic rhinitis were excluded. Outcomes assessed included the frequency and period prevalence of montelukast deprescribing, defined by a documented montelukast discontinuation within the medical record, and evaluation of reasoning for discontinuation mentioned in visit notes.
Results: There were 1152 patients who met inclusion criteria. Of these, 43 (3.7 %) experienced a montelukast deprescribing event: 18 (41.9 %) in neurology, 13 (30.2 %) in otolaryngology, and 12 (27.9 %) in pulmonology. Documented reasons for deprescribing were only available for 11 patients (25.6 %); reasons for deprescribing included patient-provider shared decision-making regarding the Black Box Warning [ n  = 5 (11.6 %)], inadequate treatment response [ n  = 3 (7.0 %)], suicidal thought development [ n  = 1 (2.3 %)], adverse drug event [ n  = 1 (2.3 %)], and pregnancy planning [ n  = 1 (2.3 %)].
Conclusion: Montelukast deprescribing rates were less than 5 % in outpatient specialty clinics. Factors associated with montelukast deprescribing beget further investigation.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Paul M Boylan reports a relationship with Pfizer Inc. that includes: funding grants. Paul M Boylan reports a relationship with Pharmacy Times Office of Continuing Professional Education LLC that includes: speaking and lecture fees. Grant H Skrepnek reports a relationship with Pfizer Inc. that includes: funding grants. Grant H Skrepnek reports a relationship with Otsuka America Pharmaceutical Inc. that includes: funding grants. Grant H Skrepnek reports a relationship with Janssen Scientific Affairs that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2024 The Authors.)