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https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#1
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28764753/supporting-prescribing-in-older-people-with-multimorbidity-and-significant-polypharmacy-in-primary-care-sppire-a-cluster-randomised-controlled-trial-protocol-and-pilot
#2
Caroline McCarthy, Barbara Clyne, Derek Corrigan, Fiona Boland, Emma Wallace, Frank Moriarty, Tom Fahey, Carmel Hughes, Paddy Gillespie, Susan M Smith
BACKGROUND: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care...
August 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28752589/frailty-and-potentially-inappropriate-medication-use-at-nursing-home-transition
#3
Laura C Maclagan, Colleen J Maxwell, Sima Gandhi, Jun Guan, Chaim M Bell, David B Hogan, Nick Daneman, Sudeep S Gill, Andrew M Morris, Lianne Jeffs, Michael A Campitelli, Dallas P Seitz, Susan E Bronskill
BACKGROUND/OBJECTIVES: To estimate the prevalence of potentially inappropriate medication (PIM) use among older adults with cognitive impairment or dementia prior to and following admission to nursing homes and in relation to frailty. DESIGN: Retrospective cohort study using health administrative databases. SETTING: Ontario, Canada. PARTICIPANTS: 41,351 individuals with cognitive impairment or dementia, aged 66+ years newly admitted to nursing home between 2011 and 2014...
July 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#4
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28720634/physician-factors-associated-with-polypharmacy-and-potentially-inappropriate-medication-use
#5
Kenya Ie, Maria Felton, Sydney Springer, Stephen A Wilson, Steven M Albert
BACKGROUND: Despite accumulating evidence about the harm of polypharmacy in family medicine, few studies have investigated factors related to polypharmacy. The objective of this study was to explore factors related to physicians' prescribing behavior. METHODS: We conducted a survey of physicians at 5 family medicine residency practices and a linked health record review of their patients ≥65 years old. The determinants of physicians' mean number of prescriptions and potentially inappropriate medications (PIMs) were examined using a generalized linear model...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28700758/deprescribing-a-simple-method-for-reducing-polypharmacy
#6
Kathryn McGrath, Emily R Hajjar, Chandrika Kumar, Christopher Hwang, Brooke Salzman
Polypharmacy brings with it increased risks for adverse drug events and reduced functional capacity. This 4-step plan will help you safely deprescribe in older adults.
July 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28694287/is-deprescribing-swimming-against-the-tide
#7
Sarah Burbank
No abstract text is available yet for this article.
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#8
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28694261/in-this-issue-trends-prescribing-deprescribing
#9
EDITORIAL
Kurt C Stange
No abstract text is available yet for this article.
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28680175/outcome-after-discontinuation-of-proton-pump-inhibitors-at-a-residential-care-site-quality-improvement-project
#10
Candy Lee, Anita Lo, Kiran Ubhi, Michael Milewski
BACKGROUND: Increased prescribing of proton pump inhibitors (PPIs) in the past few decades can be attributed mainly to long-term use of this type of therapy. Recent evidence indicates signals of harm associated with long-term use of PPIs, such as increased risk of Clostridium difficile infection, recurrence of C. difficile infection, and fracture. A few studies have assessed the effectiveness of step-down management of patients receiving long-term PPI therapy in ambulatory care settings...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28659157/supporting-medication-discontinuation-provider-preferences-for-interventions-to-facilitate-deprescribing
#11
Amy Linsky, Mark Meterko, Kelly Stolzmann, Steven R Simon
BACKGROUND: One approach to prevent adverse drug events is to discontinue ("deprescribe") medications that are outdated, not indicated, or of limited benefit relative to risk for a particular patient. However, there is little guidance to clinicians about how to integrate the process of deprescribing into the workflow of clinical practice. We sought to determine clinical prescribers' preferences for interventions that would improve their ability to appropriately and proactively discontinue medications...
June 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28648901/the-asia-pacific-clinical-practice-guidelines-for-the-management-of-frailty
#12
Elsa Dent, Christopher Lien, Wee Shiong Lim, Wei Chin Wong, Chek Hooi Wong, Tze Pin Ng, Jean Woo, Birong Dong, Shelley de la Vega, Philip Jun Hua Poi, Shahrul Bahyah Binti Kamaruzzaman, Chang Won, Liang-Kung Chen, Kenneth Rockwood, Hidenori Arai, Leocadio Rodriguez-Mañas, Li Cao, Matteo Cesari, Piu Chan, Edward Leung, Francesco Landi, Linda P Fried, John E Morley, Bruno Vellas, Leon Flicker
OBJECTIVE: To develop Clinical Practice Guidelines for the screening, assessment and management of the geriatric condition of frailty. METHODS: An adapted Grading of Recommendations, Assessment, Development, and Evaluation approach was used to develop the guidelines. This process involved detailed evaluation of the current scientific evidence paired with expert panel interpretation. Three categories of Clinical Practice Guidelines recommendations were developed: strong, conditional, and no recommendation...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28610526/considering-patient-experience-and-evidence-based-choice-of-medicines-in-medicines-optimisation
#13
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
#14
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
#15
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
#16
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
#17
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
#18
(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
#19
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
#20
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...
July 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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