User:Esteed6608/Deprescribing

From Wikipedia, the free encyclopedia

Deprescribing

Deprescribing[edit]

Deprescribing is the process of tapering, withdrawing, discontinuing or stopping medications to reduce polypharmacy, adverse drug effects and inappropriate or ineffective medication use. It involves re-evaluating the ongoing reasons for, and effectiveness of medication therapy. It is often applied for those with chronic conditions, for the elderly and for those who have a limited life expectancy. In all of these situations, polypharmacy can contribute to an increased risk of adverse events, and people may benefit from a reduction in medication use.

Deprescribing is a targeted process performed by medical professionals that can be effective in reducing medication burden in patients to improve quality of life while maintaining control of chronic conditions. Cite error: A <ref> tag is missing the closing </ref> (see the help page). tags which will then appear here automatically -->

1. Gnjidic D, Le Couteur DG, Kouladjian L, Hilmer SN. Deprescribing trials: methods to reduce polypharmacy and the impact on prescribing and clinical outcomes. ClinGeriatr Med 2012;28:237–253. 2. Cao YJ, et al. Physical and cognitive performance and burden of anticholinergics, sedatives, and ACE inhibitors in older women. Clinical Pharmacology and Therapeutics 2008, 83:422-429. 3. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J GeriatrPharmacother 2007;5(4):345-351. 4. Hilmer SN, Gnjidic D, Le Couteur DG. Thinking through the medication list - appropriate prescribing and deprescribing in robust and frail older patients. Aust Fam Physician. 2012 Dec;41(12):924-8. 5. Lee SP, Bain KT, Maio V. Appropriate discontinuation of medications at the end of life: a need to establish consensus criteria. Am J Med Qual. 2007;22 (6):393-394. 6. Sabayan B, Oleksik AM, Maier AB, van Buchem MA, Poortvliet RK, de Ruijter W, Gussekloo J, de Craen AJ, Westendorp RG.. High Blood Pressure and Resilience to Physical and Cognitive Decline in the Oldest Old: The Leiden 85-Plus Study. J Am Geriatr Soc 60:2014–2019, 2012. 7. Kirkman SM, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, Huang ES, Korytkowski MT, Munshi MN, Odegard PS, Pratley RE, Swift CS;Consensus Development Conference on Diabetes and Older Adults. Diabetes in older adults: a consensus report. J Am Geriatr Soc. 2012 Dec;60(12):2342-56. doi: 10.1111/jgs.12035. Epub 2012 Oct 25. 8. Petersen LK, Christensen K, Kragstrup J. Lipid lowering treatment to the end? A review of observational studies and RCTs on cholesterol and mortality in 80+-year olds. Age and Ageing 2010; 39: 674–680 doi: 10.1093/ageing/afq129 9. Hilmer SN, McLachlan AJ, Le Couteur DG. Clinical Pharmacology in the Geriatric Patient. Fundam Clin Pharmacol. 2007 Jun;21(3):217-30. 10. Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost-effective geriatric-palliative approach for improving drug therapy in disabled elderly people. IMAJ 2007;9:430–34.Hardy JE, Hilmer SN. 11. Iyer S, Naganathan V, McLachlan AJ, Le Couteur DG. Medication withdrawal trials in people aged 65 years and older: a systematic review. Drugs Aging 2008;25(12): 1021-31. 12. Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults. Arch Intern Med. 2010;170(18):1648-54. 13. Graves T, Hanlon JT, Schmader KE, Landsman PB, Samsa GP, Pieper CF, Weinberger M. Adverse events after discontinuing medications in elderly outpatients. Arch Intern Med. 1997 Oct 27;157(19):2205-10. 14. Woodward MC. Deprescribing: Achieving better health outcomes for older people through reducing medications. J Pharm Pract Res 2003;33:323–328. 15. Bain KT, Holmes HM, Beers MH, Maio V, Handler SM, Pauker SG. Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process. J Am Geriatr Soc. 2008 Oct;56(10):1946-52. doi: 10.1111/j.1532-5415.2008.01916.x 16. Alexander GC, Sayla MA, Holmes HM, Sachs GA. Prioritizing and stopping prescription medicines. CMAJ. 2006 Apr 11;174(8):1083-4. 17. Common oral medications that may need tapering. Pharmacist’s Letter/Prescriber’s Letter 2008;24(12):241208. 18. Nelson MR, Reid CM, Krum H, et al. Predictors of normotension on withdrawal of antihypertensive drugs in elderly patients: prospective study in second Australian National Blood - Pressure Study cohort. BMJ 2002; 325: 815-9. 19. Straand J, Fugelli P, Laake K. Withdrawing long-term diuretic treatment among elderly patients in general practice. Fam Pract 1993;10:38-42. 20. Cohen-Mansfield J, Lipson S, Werner, P, et al. Withdrawal of haloperidol, thioridazine, and lorazepam in the nursing home. Arch Intern Med 1999;159:1733-40. 21. Fair JF. Supervised withdrawal of long-term digoxin therapy. Fam Pract 1990; 7: 56-9. 22. Choudhury AB, Dawson CM, Kilvington HE. Withdrawal of inhaled corticosteroids in people with COPD in primary care: a randomised controlled trial. Resp Res 2007;8(93):1-12. 23. Bergh S, Selbaek G, Engedal K. Discontinuation of antidepressants in people with dementia and neuropsychiatric symptoms (DESEP study): double blind, randomised, parallel group, placebo controlled trial. BMJ 2012;344:e1566. 24. Campbell AJ, Robertson MC, Gardner MM, et al. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc 1999; 47: 850-3. 25. van der Velde N, Stricker BH, Huib AP, Tischa JM. Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol 2007;63(2):232-37. 26. Björnsson E, Abrahamsson H, Simrén M, Mattsson N, Jensen C, Agerforz P, Kilander A. Discontinuation of proton pump inhibitors in patients on long-term therapy: a double-blind, placebo-controlled trial. Aliment Pharmacol Ther. 2006 Sep 15;24(6):945-54. 27. Zarowitz BJ. The challenge of discontinuing proton pump inhibitors. Geriatr Nurs. 2011 Jul-Aug;32(4):276-8. doi: 10.1016/j.gerinurse.2011.06.002 28. Black DM, Schwartz AV, Ensrud KE, et al. Effects of continuing or stopping alendronate after 5 years of treatment. JAMA 2006;296:2927-38. 29. Schuling J, Gebben H, Veehof LJG, Haaijer-Ruskamp FM. Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study. BMC Family Practice 2012; 13:56-62. 30. Linsky A, Simon SR. Reversing Gears: Discontinuing Medication Therapy to Prevent Adverse Events: Comment on "Proton Pump Inhibitors and Risk of 1-Year Mortality and Rehospitalization in Older Patients Discharged From Acute Care Hospitals" JAMA Intern Med. 2013 Mar 4:1-2. doi: 10.1001/jamainternmed.2013.4068. [Epub ahead of print]


Other Refs

1. Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: the prescribing cascade. BMJ 2007;315:1096 2. Ramage-Morin P. Medication use among senior Canadians. Health Reports 2009;20(1), Catalogue no. 82-003-XPE. 3. Hayes BD, Klein-Schwartz W, Barrueto F. Polypharmacy and the geriatric patient. ClinGeriatr Med 2007;23:371–390. 4. Anthierens S, Tansens A, Petrovic M, Christiaens T. Qualitative insights into general practitioners’ views on polypharmacy. BMC FamPract 2010;11:6 5. Drugs claims by seniors: an analysis focusing on potentially inappropriate medication use, 2000 to 2006 [book on the internet]. Ottawa: Canadian Institute for Health Information; 2007 [cited 2012 Nov 4]. Available from: https://secure.cihi.ca/.../Potentially_Inappropriate_Medications_EN.pdf. 6. Zulman D, Sussman JB, Chen X, Cigolle CT, Blaum CS, Hayward RA. Examining the evidence: a systematic review of the inclusion and analysis of older adults in randomized controlled trials. J Gen Intern Med 2011;26(7):783-790. 7. Nadeem NJ, Taylor S, Eldridge S. Withdrawal of inhaled corticosteroids in individuals with COPD – a systematic review and comment on trial methodology. Resp Res 2011;12(107):1-10. 8. Best Practice Journal. A practical guide to stopping medicines in older people. Best Pract J 2010;27:10-23 9. Holmes HM, Hayley DC, Alexander GC, Sachs GA. Reconsidering medicine appropriateness for patients late in life. Arch Intern Med 2006;166:605-9 10. van Duijn HJ, Belo JN, Blom JW, Velberg ID, Assendelft WJ. Revised guidelines for cardiovascular risk management - time to stop medication? A practice-based intervention study. Br J Gen Pract. 2011 Jun;61(587):e347-52. doi: 10.3399/bjgp11X578025. 11. Lader M, Tylee A, Donoghue J. Withdrawing benzodiazepines in primary care. CNS Drugs. 2009;23(1):19-34. doi: 10.2165/0023210-200923010-00002. 12. Lee YS, Choo MS, Lee JY, Oh SJ, Lee KS. Symptom change after discontinuation of successful antimuscarinic treatment in patients with overactive bladder symptoms: a randomised, multicentre trial. Int J Clin Pract 2011;65(9): 997–1004. 13. Chae SY, Chae MH, Isaacson N, James TS. The patient medication list: can we get patients more involved in their medical care?. J Am Board Fam Med. 2009 Nov-Dec;22(6):677-85. doi: 10.3122/jabfm.2009.06.090059.

External links[edit]