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https://www.readbyqxmd.com/read/28913911/older-adults-awareness-of-deprescribing-a-population-based-survey
#1
Justin P Turner, Cara Tannenbaum
OBJECTIVES: To determine older adults' awareness of the concept of medication-induced harm and their familiarity with the term "deprescribing." Secondary objectives were to ascertain determinants of self-initiated deprescribing conversations and to identify how older adults seek information on medication harms. DESIGN: Cross-sectional population-based household telephone survey using random-digit dialling. SETTING: Canada. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74...
September 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28895169/we-have-had-a-gutful-the-need-for-deprescribing-proton-pump-inhibitors
#2
M Naunton, G M Peterson, L S Deeks, H Young, S Kosari
WHAT IS KNOWN AND OBJECTIVE: Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. METHODS: Australian Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) data were analysed...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28887346/leveraging-electronic-medical-record-data-for-population-health-management-in-the-veterans-health-administration-successes-and-lessons-learned
#3
Jannet M Carmichael, Joy Meier, Amy Robinson, Janice Taylor, Diana T Higgins, Shardool Patel
PURPOSE: The process and operational elements to establish a population health program using electronic medical record data in a Veterans Health Administration region are described. SUMMARY: Pharmacists are uniquely qualified to assume important roles in population health through the use of their clinical knowledge, assisted by electronic tools that consolidate and report patient-specific data for clinical care. Veterans Integrated Services Network (VISN) 21 has developed 300 dashboards and reports to improve the quality, safety, and value of healthcare to veterans...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28870834/prevalence-of-preventive-cardiovascular-medication-use-in-nursing-home-residents-room-for-deprescribing-the-shelter-study
#4
Alireza Malek Makan, Hein van Hout, Graziano Onder, Harriet Finne-Soveri, Henriëtte van der Roest, Rob van Marum
INTRODUCTION: In nursing home (NH) residents with a very short life expectancy, the benefits of preventive cardiovascular medication maintenance are questionable. OBJECTIVE: To assess the prevalence of 4 classes of preventive cardiovascular medication (PCM) in NH residents, and to explore differences of prevalence across length of stay, mortality risk, cognitive impairment, functional disability, and across countries. METHODS: A 12-month prospective cohort study was conducted in 57 NHs in 8 countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands, and Israel)...
September 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28860728/patient-provider-concordance-in-the-perception-of-illness-and-disease-a-cross-sectional-study-among-multimorbid-patients-and-their-general-practitioners-in-switzerland
#5
Stefan Neuner-Jehle, Stefan Zechmann, Daniela Grundmann Maissen, Thomas Rosemann, Oliver Senn
BACKGROUND: Multiple chronic health conditions are leading to multiple treatment procedures and polypharmacy. Prioritizing treatment according to patients' needs and preferences may be helpful for deprescribing. Thus, for improving health care, it is crucial for general practitioners (GPs) to perceive the chief complaints (CCs) of patients. The primary aim of this study was to investigate the patient-provider concordance of CCs and the secondary aim was to investigate the concordance between CCs and diagnosis, in a sample of Swiss multimorbid patients...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28853000/discontinuation-of-preventive-medicines-in-older-people-with-limited-life-expectancy-a-systematic-review
#6
REVIEW
Sujita W Narayan, Prasad S Nishtala
BACKGROUND: In the presence of multimorbidity and limited life expectancy (LLE), the need for continued use of preventive medicines becomes uncertain as they may neither improve health nor confer continued health benefits. OBJECTIVE: Our objective was to systematically review the literature to examine the discontinuation of preventive medicines in older people with LLE. METHODS: A systematic literature search was conducted using the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register databases...
August 29, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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