The use of drugs has undeniable benefits to the elderly, but it is not exempt from undesirable effects. Deprescription is the process of systematic medication review with the target of achieving the best risk-benefit ratio based on the best available evidence. This process is especially important for polymedicated elderly patients as well as those overtreated, frail, terminally ill and at the end of life. The deprescription must be done in stages, establishing a close follow-up in case problems appear after withdrawal. In the decision-making process, it is very important to consider the patient and caregivers opinion, assessing the objectives of the treatment according to the clinical, functional and social situation of the patient. There are multiple tools to make it easier for clinicians to select which drugs to deprescribe (Beers criteria, STOPP-START…). The most susceptible to intervention pharmacological groups are: antihypertensives, antidiabetics, statins, benzodiazepines, antidepressants, anticholinergics, anticholinesterase agents, and neuroleptics.
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| http://dx.doi.org/10.1016/j.aprim.2022.102367 | 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 PDFDeprescribing attitudes and predictors among older adults attending geriatric clinics in Kuwait.
PLoS One
December 2024
Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.
Deprescribing is defined as the reduction of medications to improve patient care. For effective deprescribing regular evaluation of medication adjustment regimens is required as it is documented to be an effective method to reduce polypharmacy and potentially inappropriate medications while improving patient well-being. Several factors, including patient-related aspects, influence the deprescribing process.
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Background: Advancing age and chronic kidney disease (CKD) are risk factors for polypharmacy. Polypharmacy is associated with negative healthcare outcomes. Deprescribing, the systematic rationalization of potentially inappropriate medications, is a proposed way of addressing polypharmacy.
View Article and Find Full Text PDFUnderstanding European patterns of deprescribing antithrombotic medication during end-of-life care in patients with cancer.
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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:
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Population aging is a global phenomenon that is increasing the proportion of older people, particularly those over 80 years old. This increase in longevity does not always translate into years of good quality of life. This document reviews the latest evidence on the main preventive activities for older adults, starting with major geriatric syndromes such as frailty, cognitive impairment, and social isolation.
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