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https://www.readbyqxmd.com/read/29760253/deprescribing-benzodiazepine-receptor-agonists-evidence-based-clinical-practice-guideline
#1
Kevin Pottie, Wade Thompson, Simon Davies, Jean Grenier, Cheryl A Sadowski, Vivian Welch, Anne Holbrook, Cynthia Boyd, Robert Swenson, Andy Ma, Barbara Farrell
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop benzodiazepine receptor agonists (BZRAs); 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: The overall team comprised 8 clinicians (1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists, and 1 geriatrician) and a methodologist; members disclosed conflicts of interest...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29708955/deprescribing-in-older-people-why-it-matters-in-routine-clinical-practice
#2
Denis O'Mahony, Denis Curtin
No abstract text is available yet for this article.
April 30, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29705831/deprescribing-benzodiazepines-in-older-patients-impact-of-interventions-targeting-physicians-pharmacists-and-patients
#3
REVIEW
Brendan J Ng, David G Le Couteur, Sarah N Hilmer
Benzodiazepines (BZDs; including the related Z-drugs) are frequently targets for deprescribing; long-term use in older people is harmful and often not beneficial. BZDs can result in significant harms, including falls, fractures, cognitive impairment, car crashes and a significant financial and legal burden to society. Deprescribing BZDs is problematic due to a complex interaction of drug, patient, physician and systematic barriers, including concern about a potentially distressing but rarely fatal withdrawal syndrome...
April 28, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29688246/drug-consumption-and-futile-medication-prescribing-in-the-last-year-of-life-an-observational-study
#4
D Curtin, D O'Mahony, P Gallagher
Background: the last year of life for many older people is associated with high symptom burden and frequent hospitalizations. Hospital physicians have an opportunity to prioritize essential medications and deprescribe potentially futile medications. Objective: to measure medication consumption during hospitalization in the last year of life and the prevalence of potentially inappropriate medications (PIMs) at hospital discharge. Design: retrospective chart review...
April 23, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29682764/how-confident-are-physicians-in-deprescribing-for-the-elderly-and-what-barriers-prevent-deprescribing
#5
L Djatche, S Lee, D Singer, S E Hegarty, M Lombardi, V Maio
WHAT IS KNOWN AND OBJECTIVE: Deprescribing is the process of discontinuing or reducing the dosage of medications that are no longer appropriate or aligned with goals of care, which is paramount in elderly patients with multiple comorbidities and polypharmacy. The objective of this study was to assess the perceptions of primary care physicians on deprescribing for elderly patients and potential barriers to deprescribing that physicians experience in the Local Health Authority (LHA) of Parma, Emilia-Romagna, Italy...
April 22, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29678989/prescribing-and-deprescribing-antihypertensive-medication-in-older-people-by-dutch-general-practitioners-a-qualitative-study
#6
Tessa van Middelaar, Sophie D Ivens, Petra G van Peet, Rosalinde K E Poortvliet, Edo Richard, A Jeannette Pols, Eric P Moll van Charante
OBJECTIVES: To explore general practitioners' (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. DESIGN: Semistructured interviews. SETTING: Dutch general practice. PARTICIPANTS: Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678983/older-patients-perception-of-deprescribing-in-resource-limited-settings-a-cross-sectional-study-in-an-ethiopia-university-hospital
#7
Henok Getachew Tegegn, Yonas Getaye Tefera, Daniel Asfaw Erku, Kaleab Taye Haile, Tamrat Befekadu Abebe, Fasil Chekol, Yonas Azanaw, Asnakew Achaw Ayele
OBJECTIVE: To assess older patients' attitude towards deprescribing of inappropriate medications. DESIGN: This was an institutional-based, quantitative, cross-sectional survey. SETTING: Outpatient clinics of the University of Gondar Referral and Teaching Hospital in Ethiopia. PARTICIPANTS: Patients aged 65 or older with at least one medication were enrolled in the study from 1 March to 30 June 2017. Excluded patients were those who had severe physical or psychological problems and who refused to participate...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29665778/characteristics-of-elderly-patients-with-polypharmacy-who-refuse-to-participate-in-an-in-hospital-deprescribing-intervention-a-retrospective-cross-sectional-study
#8
Junpei Komagamine, Kenichi Sugawara, Kazuhiko Hagane
BACKGROUND: Few studies have evaluated the characteristics of elderly patients with polypharmacy refusing deprescribing. The aim of this study was to evaluate the prevalence of potentially inappropriate medication (PIM) use in elderly patients accepting and refusing a deprescribing intervention and to investigate factors associated with deprescribing refusal. METHODS: We conducted a retrospective cross-sectional study by analyzing the electronic medical records from a single hospital...
April 17, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29659717/statin-treatment-is-associated-with-a-neutral-effect-on-health-related-quality-of-life-among-community-dwelling-octogenarian-men
#9
Timo E Strandberg, Annele Urtamo, Juuso Kähärä, Arto Y Strandberg, Kaisu H Pitkälä, Hannu Kautiainen
Background: Statin treatment is common among 80+ people, but little is known about statin effects on health-related quality of life (HRQoL) in this oldest age group. Methods: In the Helsinki Businessmen Study (HBS), men born 1919 to 1934 (original n=3490), have been followed-up since the 1960s. In 2015, a questionnaire about lifestyle, diseases and medications, and including RAND-36/SF-36 HRQoL instrument was mailed to survivors. 612 men (72.6%) responded, 530 of them reporting their medications (98% community-living)...
April 12, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29659552/improving-pharmacists-targeting-of-patients-for-medication-review-and-deprescription
#10
Vanessa Marvin, Emily Ward, Barry Jubraj, Mark Bower, Iñaki Bovill
Background: In an acute hospital setting, a multi-disciplinary approach to medication review can improve prescribing and medicine selection in patients with frailty. There is a need for a clear understanding of the roles and responsibilities of pharmacists to ensure that interventions have the greatest impact on patient care. Aim: To use a consensus building process to produce guidance for pharmacists to support the identification of patients at risk from their medicines, and to articulate expected actions and escalation processes...
April 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29659488/does-a-consumer-targeted-deprescribing-intervention-compromise-patient-healthcare-provider-trust
#11
Yi Zhi Zhang, Justin P Turner, Philippe Martin, Cara Tannenbaum
One in four community-dwelling older adults is prescribed an inappropriate medication. Educational interventions aimed at patients to reduce inappropriate medications may cause patients to question their prescriber’s judgment. The objective of this study was to determine whether a patient-focused deprescribing intervention compromised trust between older adults and their healthcare providers. An educational brochure was distributed to community-dwelling older adults by community pharmacists in order to trigger deprescribing conversations...
April 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29650870/-efforts-of-deprescribing-drugs-and-its-achievements-in-institutionalized-individuals
#12
Noriaki Mitsuya, Yukinori Oshima, Tomoki Yamauchi, Akira Oguchi, Noboru Hashimoto, Asuka Soga, Yuki Nagahori, Ken Yamamoto, Masayoshi Hirohara, Kazuki Kushida
Recently, the combined use of multiple drugs for coexisting multiple diseases in elderly patients has become a problem. In facilities for elderly persons, pharmacists contribute to the intervention and optimization of prescriptions. However, the procedures have been conducted smoothly in only a few facilities. We established five procedures for prescription intervention by pharmacists and implemented these interventions in 80 institutionalized individuals. The total results over 2 years(January 1, 2015 to December 31, 2016)revealed 118 cases of prescription proposals from pharmacists and a reduction of 2,411,937 yen in medical expense...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29574073/selective-prescribing-of-statins-and-the-risk-of-mortality-hospitalizations-and-falls-in-aged-care-services
#13
Maarit J Korhonen, Jenni Ilomäki, Janet K Sluggett, M Alan Brookhart, Renuka Visvanathan, Tina Cooper, Leonie Robson, J Simon Bell
BACKGROUND: Compared to randomized controlled trials, nonexperimental studies often report larger survival benefits but higher rates of adverse events for statin use vs nonuse. OBJECTIVE: We compared characteristics of statin users and nonusers living in aged care services and evaluated the relationships between statin use and all-cause mortality, all-cause and fall-related hospitalizations, and number of falls during a 12-month follow-up. METHODS: A prospective cohort study of 383 residents aged ≥65 years was conducted in six Australian aged care services...
March 2, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29568537/a-province-wide-cross-sectional-study-of-demographics-and-medication-use-of-patients-in-hemodialysis-units-across-ontario
#14
Marisa Battistella, Racquel Jandoc, Jeremy Y Ng, Eric McArthur, Amit X Garg
Background: Hemodialysis patients are at an increased risk of polypharmacy as they have the highest pill burden of all chronically ill patient populations, with an estimated average of 12 medications per day. Objectives: The aim of this study was to evaluate prescribing patterns of outpatient medications in patients receiving in-center hemodialysis. This was done to identify potential candidate medications for future quality improvement initiations to optimize prescribing...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29541966/impact-of-deprescribing-interventions-in-older-hospitalised-patients-on-prescribing-and-clinical-outcomes-a-systematic-review-of-randomised-trials
#15
REVIEW
Janani Thillainadesan, Danijela Gnjidic, Sarah Green, Sarah N Hilmer
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults in hospital, and are associated with negative outcomes including adverse drug reactions, falls, confusion, hospitalisation and death. Deprescribing may reduce inappropriate polypharmacy and use of inappropriate medications. OBJECTIVE: The aim of this systematic review was to investigate the efficacy of deprescribing interventions in older inpatients to reduce PIMs and impact on clinical outcomes...
April 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29531631/a-prototype-for-evidence-based-pharmaceutical-opinions-to-promote-physician-pharmacist-communication-around-deprescribing
#16
Philippe Martin, Cara Tannenbaum
Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians' views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada...
March 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29522385/deprescribing-when-trying-for-less-is-more
#17
EDITORIAL
Brian F Mandell
No abstract text is available yet for this article.
March 2018: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29515446/is-excessive-polypharmacy-a-transient-or-persistent-phenomenon-a-nationwide-cohort-study-in-taiwan
#18
Yi-Jen Wang, Shu-Chiung Chiang, Pei-Chen Lee, Yu-Chun Chen, Li-Fang Chou, Yueh-Ching Chou, Tzeng-Ji Chen
Objectives: Target populations with persistent polypharmacy should be identified prior to implementing strategies against inappropriate medication use, yet limited information regarding such populations is available. The main objectives were to explore the trends of excessive polypharmacy, whether transient or persistent, at the individual level. The secondary objectives were to identify the factors associated with persistently excessive polypharmacy and to estimate the probabilities for repeatedly excessive polypharmacy...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29500163/deprescribing-in-nursing-homes-is-safe-and-should-be-pursued
#19
Eline Tommelein
No abstract text is available yet for this article.
April 2018: Evidence-based Nursing
https://www.readbyqxmd.com/read/29493634/-medication-adherence-in-cardiovascular-diseases
#20
Alberto Dolara
Nonadherence to medications is common in cardiovascular diseases because of their long duration, the patient age and the complexity of therapy. Its prevalence depends on the population, the types of drugs and the disease under study. Adherence decreases from the initial prescription and it is usually under 80%, a value defined as satisfactory. Adverse outcomes of nonadherence consist of an increase in ambulatory visits and hospitalization and death rates. The causes of nonadherence are multiple and depend on the patient, the type of medication, the healthcare professional, and the health system...
February 2018: Recenti Progressi in Medicina
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