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Deprescribing

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https://www.readbyqxmd.com/read/28610526/considering-patient-experience-and-evidence-based-choice-of-medicines-in-medicines-optimisation
#1
Gerri Kaufman, Ann Bellerby, Mike Kitching
Medicines optimisation can be used by healthcare professionals to support patients to gain maximum benefit from their medicines, with two of the main principles being understanding the patient experience and ensuring medicines choice is evidence-based. Non-adherence is a significant issue in medicines management. Relational aspects of the patient experience, such as empathetic two-way communication between the healthcare professional and patient, the provision of clear information and shared decision-making, can have a positive influence on whether patients take their medicines as intended...
June 14, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28608038/patient-values-and-preferences-surrounding-proton-pump-inhibitor-use-a-scoping-review
#2
REVIEW
Wade Thompson, Cody Black, Vivian Welch, Barbara Farrell, Lise M Bjerre, Peter Tugwell
BACKGROUND: Proton pump inhibitors (PPIs) treat various upper gastrointestinal (GI) diseases. Around 50% of patients may remain on PPIs long-term without ongoing need. Eligible patients should be offered the choice of continuing their PPI or trying to reduce/stop their PPI (deprescribing), a choice dependent on values and preferences. OBJECTIVES: Our objective was to systematically scope the available evidence on patient values and preferences surrounding continued PPI treatment and/or the decision to try a reduction in their PPI...
June 12, 2017: Patient
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#3
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28579760/understanding-deprescribing-of-preventive-cardiovascular-medication-a-q-methodology-study-in-patients
#4
Clare H Luymes, Nelleke J Boelhouwer, Rosalinde Ke Poortvliet, Wouter de Ruijter, Ria Reis, Mattijs E Numans
BACKGROUND: Patients with low cardiovascular disease (CVD) risk potentially use preventive cardiovascular medication unnecessarily. Our aim was to identify various viewpoints and beliefs concerning the preventive CVD management of patients with low CVD risk using preventive cardiovascular medication. Furthermore, we investigated whether certain viewpoints were related to a preference for deprescription or the continuation of preventive cardiovascular medication. METHODS: In 2015, we purposively sampled patients from the intervention arm of the Evaluating Cessation of STatins and Antihypertensive Treatment In primary Care (ECSTATIC) trial in the Netherlands for this study...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28573879/does-cardiovascular-comorbidity-influence-the-prescribing-of-bronchodilators-in-chronic-obstructive-pulmonary-disease
#5
Damilola T Adesanoye, Cynthia J Willey
BACKGROUND: Cardiovascular disease (CVD) is the most prevalent comorbidity for chronic obstructive pulmonary disease (COPD). Potential adverse cardiovascular events of bronchodilators warrant their cautionary use in the comorbid COPD-CVD population, yet little is known about the prescribing of bronchodilators in this high-risk patient group. OBJECTIVE: To determine whether comorbid CVD is associated with reduced bronchodilator prescribing in patients with COPD. In addition, we explored how the association was modified by gender, concurrent asthma, and concomitant β-blocker (BB) use...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28547787/prescribing-and-research-in-medicines-management-uk-ireland-annual-conference-2017-university-of-coventry-london-campus-january-28-th-2017-deprescribing-is-less-more
#6
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28544188/novel-tool-for-deprescribing-in-chronic-patients-with-multimorbidity-list-of-evidence-based-deprescribing-for-chronic-patients-criteria
#7
Aitana Rodríguez-Pérez, Eva Rocío Alfaro-Lara, Sandra Albiñana-Perez, María Dolores Nieto-Martín, Jesús Díez-Manglano, Concepción Pérez-Guerrero, Bernardo Santos-Ramos
AIM: To create a tool to identify drugs and clinical situations that offers an opportunity of deprescribing in patients with multimorbidity. METHODS: A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the literature and brainstorming as possible situations for deprescribing. They were also asked to assess the influence of life prognosis in each criterion...
May 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28533200/beliefs-about-prescribed-medication-among-older-patients-with-polypharmacy-a-mixed-methods-study-in-primary-care
#8
Barbara Clyne, Janine A Cooper, Fiona Boland, Carmel M Hughes, Tom Fahey, Susan M Smith
BACKGROUND: Polypharmacy (≥5 medications) is common in older patients and is associated with adverse outcomes. Patients' beliefs about medication can influence their expectations for medication, adherence, and willingness to deprescribe. Few studies have examined beliefs about prescribed medication among older patients with polypharmacy in primary care. AIM: To explore medication-related beliefs in older patients with polypharmacy and factors that might influence beliefs...
May 22, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28520522/perceptions-of-statin-discontinuation-among-patients-with-life-limiting-illness
#9
Jennifer Tjia, Jean S Kutner, Christine S Ritchie, Patrick J Blatchford, Rachael E Bennett Kendrick, Maryjo Prince-Paul, Tamara J Somers, Mary Lynn McPherson, Jeff A Sloan, Amy P Abernethy, Jon P Furuno
BACKGROUND: Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear. OBJECTIVE: The aim of this study was to quantify the perceived benefits and concerns of statin discontinuation among patients with life-limiting illness. DESIGN: Baseline data from a multicenter, pragmatic clinical trial of statin discontinuation were used...
May 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28500192/deprescribing-proton-pump-inhibitors-evidence-based-clinical-practice-guideline
#10
Barbara Farrell, Kevin Pottie, Wade Thompson, Taline Boghossian, Lisa Pizzola, Farah Joy Rashid, Carlos Rojas-Fernandez, Kate Walsh, Vivian Welch, Paul Moayyedi
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper or stop proton pump inhibitors (PPIs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. METHODS: Five health professionals (1 family physician, 3 pharmacists, and 1 gastroenterologist) and 5 nonvoting members comprised the overall team; members disclosed conflicts of interest...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#11
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28473524/a-realist-evaluation-of-patients-decisions-to-deprescribe-in-the-empower-trial
#12
Philippe Martin, Cara Tannenbaum
BACKGROUND AND OBJECTIVES: Successful mechanisms for engaging patients in the deprescribing process remain unknown but may include: (1) triggering motivation to deprescribe by increasing patients' knowledge and concern about medications; (2) building capacity to taper by augmenting self-efficacy and (3) creating opportunities to discuss and receive support for deprescribing from a healthcare provider. We tested these mechanisms during theEliminating Medications through Patient Ownership of End Results (EMPOWER) () trial and investigated the contexts that led to positive and negative deprescribing outcomes...
May 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28458294/deprescribing-using-the-guidelines-for-medical-treatment-and-its-safety-in-the-elderly-and-changes-in-patient-qol-and-activities-of-daily-living
#13
Shigeru Ohshima, Ayaka Hara, Takumi Abe, Hayato Akimoto, Kousuke Ohara, Akio Negishi, Mitsuyoshi Okita, Shinji Oshima, Naoko Inoue, Sachihiko Numajiri, Etsushi Ogawa, Minoru Saiki, Daisuke Kobayashi
 Pharmacists applied deprescribing, which is a process for the rational use of drugs, for 13 at-home patients. The standard used for the rational use of drugs was the "Guidelines for Medical Treatment and Its Safety in the Elderly" (the Guidelines). The results of the deprescribing were discussed with physicians to determine prescriptions. After the prescription change, activities of daily living (ADL) and QOL were assessed using the Barthel Index and SF-36v2, respectively. Potentially inappropriate medications (PIMs) were detected in 10 of the 13 patients (76...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28456823/a-systematic-review-of-interventions-to-deprescribe-benzodiazepines-and-other-hypnotics-among-older-people
#14
REVIEW
Emily Reeve, Magdalene Ong, Angela Wu, Jesse Jansen, Mirko Petrovic, Danijela Gnjidic
PURPOSE: Benzodiazepines are effective medicines for insomnia and anxiety but are commonly used beyond recommended treatment time frames, which may lead to adverse drug events. The aim of this systematic review was to critically evaluate the success of interventions used to reduce benzodiazepines and 'Z-drug' use, and the impact of these interventions on clinical outcomes in older adults. METHODS: A search was conducted in PubMed, Embase, Informit, International Pharmaceutical Abstracts, Scopus, PsychINFO, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL...
April 30, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28424148/evidence-based-deprescribing-of-proton-pump-inhibitors-in-long-term-care
#15
EDITORIAL
Janet K Sluggett, Ivanka Hendrix, J Simon Bell
No abstract text is available yet for this article.
April 12, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28416498/deprescribing-anticholinergic-and-sedative-medicines-protocol-for-a-feasibility-trial-defeat-polypharmacy-in-residential-aged-care-facilities
#16
Nagham Ailabouni, Dee Mangin, Prasad S Nishtala
INTRODUCTION: Targeted deprescribing of anticholinergic and sedative medicines can lead to positive health outcomes in older people; as they have been associated with cognitive and physical functioning decline. This study will examine whether the proposed intervention is feasible at reducing the prescription of anticholinergic and sedative medicines in older people. METHODS AND ANALYSIS: The Standard Protocol Items: Recommendations for Interventional trials (SPIRIT checklist) was used to develop and report the protocol...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28416321/targeted-deprescribing-in-an-outpatient-hemodialysis-unit-a%C3%A2-quality-improvement-study-to-decrease-polypharmacy
#17
Caitlin McIntyre, Rory McQuillan, Chaim Bell, Marisa Battistella
BACKGROUND: Polypharmacy in hemodialysis patients can result in adverse patient outcomes. Deprescribing tools can reduce polypharmacy, yet no method exists for an outpatient hemodialysis population. DESIGN: Quality improvement study. SETTING & PARTICIPANTS: 240 patients in a tertiary-care outpatient hemodialysis unit. QUALITY IMPROVEMENT PLAN: We aimed to: (1) develop a deprescribing tool for target medications with poor evidence for efficacy and safety, (2) determine its effectiveness in decreasing polypharmacy, and (3) monitor patient safety and satisfaction...
April 14, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28414534/deprescribing-to-improve-care
#18
Alison While
No abstract text is available yet for this article.
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28402709/how-can-we-effectively-engage-physicians-in-the-deprescribing-process
#19
Laurence Djatche, David Singer, Arianna Heyer, Marco Lombardi, Stefano Del Canale, Vittorio Maio
No abstract text is available yet for this article.
April 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28401119/long-term-sedative-use-among-community-dwelling-adults-a-population-based-analysis
#20
Deirdre Weymann, Emilie J Gladstone, Kate Smolina, Steven G Morgan
BACKGROUND: Chronic use of benzodiazepines and benzodiazepine-like sedatives (z-drugs) presents substantial risks to people of all ages. We sought to assess trends in long-term sedative use among community-dwelling adults in British Columbia. METHODS: Using population-based linked administrative databases, we examined longitudinal trends in age-standardized rates of sedative use among different age groups of community-dwelling adults (age ≥ 18 yr), from 2004 to 2013...
January 2017: CMAJ Open
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