Background: Deprescribing of medication or psychotherapy represents a critical phase in treatment. The aim of the work is to systematically analyze recommendations for deprescribing medication and discontinuation of psychotherapy in the evidence- and consensus-based S3 guidelines of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) to identify potential research gaps.
Methods: A systematic analysis of the DGPPN S3 guidelines to investigate and compare information and recommendations on deprescribing.
Results: Regarding deprescribing of medication, our analysis showed that eight of the 20 included S3 guidelines contain information both in the form of recommendations and background information. Regarding psychotherapy, only two guidelines provided information on deprescribing.
Conclusion: Our results highlight the need to expand guidelines to include evidence-based recommendations for deprescribing medication or discontinuation of psychotherapy. Future research should focus on the development of specific, generic, and evidence-based guidelines that support both medical staff and patients during these critical phases of therapy.
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http://dx.doi.org/10.1007/s00115-024-01671-z | DOI Listing |
BMJ Open
January 2025
Department of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
Objective: To map instruments for assessing healthcare professionals' knowledge, attitudes and practices regarding deprescribing.
Introduction: Deprescribing is essential for improving patient outcomes by managing polypharmacy, reducing fall risks and decreasing medication costs. However, there is a limited exploration of healthcare professionals' perspectives about deprescribing.
BMJ Open
January 2025
Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
Objectives: Proton pump inhibitors (PPIs) are widely prescribed medications and commonly used for the treatment of gastric acid-related disorders. Nevertheless, PPIs are often overused leading to potential adverse effects and unnecessary healthcare costs. Deprescribing strategies have emerged to safely reduce or substitute inappropriate PPIs and optimise patient care in an evidence-based manner.
View Article and Find Full Text PDFDrugs Aging
January 2025
Center for Clinical Management Research, VA Ann Arbor Healthcare System, NCRC 016-308E, 2800 Plymouth Rd, Ann Arbor, MI, 48109, USA.
Background: Central nervous system (CNS)-active polypharmacy (defined as concurrent exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, or nonbenzodiazepine benzodiazepine receptor agonists) is associated with significant potential harms in persons living with dementia (PLWD).We conducted a pilot trial to assess a patient nudge intervention's implementation feasibility and preliminary effectiveness to prompt deprescribing conversations between PLWD experiencing CNS-active polypharmacy and their primary care clinicians ("clinicians").
Methods: We used the electronic health record to identify PLWD prescribed CNS-active polypharmacy in primary care clinics from two health systems.
Drugs Aging
January 2025
Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Background: Preventive medications are potential targets for deprescribing in older adults with dementia as goals of care change from preventive to palliative. Yet, prescribers lack communication guidance to address deprescribing.
Objective: Using bisphosphonates as a case example, we sought to characterize and compare communication preferences of prescribers and family/informal caregivers regarding deprescribing.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
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