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| http://dx.doi.org/10.1136/ejhpharm-2017-001482 | DOI Listing |
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Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module.
J Prim Health Care
December 2024
University of Otago, Wellington, Department of Primary Health Care and General Practice, Te Whare Wananga o Otago ki Te Whanga-Nui-a-Tara, 6242, New Zealand/Aotearoa.
Introduction This study explored the experiences of students and their supervisors undertaking a medication review activity during a 6-week general practice module in their final year of medical school at University of Otago, Wellington, Aotearoa New Zealand. Aim The study sought the self-reported value of the activity in learning about prescribing, reflecting on polypharmacy, deprescribing, and changes to future practice for both student and supervisor. Methods All students in the final year general practice module were invited to complete a survey over a 12-month period, as were their supervisors.
View Article and Find Full Text PDFUnderstanding European patterns of deprescribing antithrombotic medication during end-of-life care in patients with cancer.
Thromb Res
January 2025
Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece. Electronic address:
Background: Even though antithrombotic therapy (ATT) probably has little or even negative effect on the well-being of patients with cancer near the end of life, it is often continued until death, possibly leading to excess bleeding complications, increased disease burden, reduced quality of life and higher healthcare costs.
Aim: To explore and describe European practice patterns and perspectives of healthcare professionals from different disciplines and specialties on ATT in the end-of-life care (EOLC) of patients with cancer.
Methods: We performed a two-week international cross-sectional survey study using flash-mob research methodology.
Medicare Enrollment and Spending Among Patients Initiating Dialysis After the Affordable Care Act.
JAMA Health Forum
December 2024
Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Importance: Medicare finances health care for most US patients with end-stage kidney disease (ESKD), regardless of age. Medicare enrollment may have slowed for patients with incident ESKD who gained access to new private insurance options with the 2014 passage of the Affordable Care Act (ACA) and introduction of the ACA Marketplace.
Objective: To describe trends in public and private insurance coverage and dialysis spending among patients with incident ESKD from 2012 to 2017.
Rates and predictors of opioid deprescribing after fracture: A retrospective study of Medicare fee-for-service claims.
J Am Geriatr Soc
December 2024
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Article Synopsis
- - The study focuses on opioid discontinuation rates and their predictors among older adults (65+) with Alzheimer's disease-related dementias (ADRD) or frailty who had undergone a fracture and started opioid treatment.
- - It analyzed 33,027 Medicare beneficiaries and found that about 81-83% of non-frail individuals discontinued opioids within 30 days, while those with frailty or ADRD had lower discontinuation rates (76%-77%).
- - Those with both ADRD and frailty were less likely to discontinue opioids compared to those without these conditions, indicating different opioid management needs based on health status.
Deprescribing anticholinergics to preserve brain health: reducing the risk of dementia through deprescribing (R2D2): study protocol for a randomized clinical trial.
Trials
November 2024
Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA.
Background: Older adults commonly experience chronic medical conditions and are at risk of cognitive impairment as a result of age, chronic comorbidity, and medications prescribed to manage multiple chronic conditions. Anticholinergic medications are common treatments for chronic conditions and have been repeatedly associated with poor cognitive outcomes, including delirium and dementia, in epidemiologic studies. However, no study has definitively evaluated the causal relationship between anticholinergics and cognition in a randomized controlled trial design.
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