Cited by Deprescribing Medications that Increase the Risk of Falls in Older People: Exploring Doctors' Perspectives Using the Theoretical Domains Framework (TDF)

Wade Thompson, Lisa McCarthy, Barbara Farrell

et al.

Advanced clinical pharmacy - research, development and practical applications/Advanced clinical pharmacy - research, development and practical applications, Journal Year: 2025, Volume and Issue: unknown, P. 61 - 92

Published: Jan. 1, 2025

Language: Английский

Citations

Development and Implementation of Deprescribing Guidelines DOI

Aili Langford, Frank Moriarty, Darshna Goordeen

et al.

Published: Jan. 1, 2025

Language: Английский

Citations

Development of a complex multidisciplinary medication review and deprescribing intervention in primary care for older people living with frailty and polypharmacy DOI

Eloise Radcliffe, Alejandra Recio‐Saucedo,

Clare Howard

et al.

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(4), P. e0319615 - e0319615

Published: April 22, 2025

Introduction Reducing polypharmacy and overprescribing in older people living with frailty is challenging. Evidence suggests that this could be facilitated by structured medication review (SMR) deprescribing processes involving the multidisciplinary team (MDT). This study aimed to develop an MDT SMR intervention primary care for frailty. Methods Intervention development was informed Medical Research Council framework complex behaviour change implementation theories. planning included: 1) a realist of 28 papers identified 33 context-mechanism-outcome configurations successful care, 2) qualitative 26 healthcare professionals (HCPs), 13 their informal carers. The intervention’s guiding principles were developed functions proposed, discussed refined through iterative process four online co-design stakeholder workshops. Results final version consisted five components: Proactive identification patients targeted using routinely collected data; HCPs’ preparation evidence-based tool identify prioritise high-risk medications deprescribing; 3) Preparing carers leaflet sent prior explaining purpose reasons potentially stopping or changing medications; 4) Conducting person-centred face-to-face phone, tailored patient/carer needs, other members based on expertise; 5) Tailored follow-up plans allowing continuity highlighting signs symptoms monitor, arranging text, phone appointment. Conclusion A address multiple challenges deprescribing. use rigorous methods theories maximises feasibility, acceptability implementation.

Language: Английский

Citations

Pharmacotherapy De-Escalation as a Critical Component of Lifestyle Medicine DOI

Jeffrey I. Mechanick

Lifestyle Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 605 - 616

Published: Jan. 1, 2025

Language: Английский

Citations

Optimising a person-centred approach to stopping medicines in older people with multimorbidity and polypharmacy using the DExTruS framework: a realist review DOI

Amadea Turk, G. Wong, Kamal R Mahtani

et al.

BMC Medicine, Journal Year: 2022, Volume and Issue: 20(1)

Published: Aug. 31, 2022

Abstract Background Tackling problematic polypharmacy requires tailoring the use of medicines to individual circumstances and may involve process deprescribing. Deprescribing can cause anxiety concern for clinicians patients. Tailoring medication decisions often entails beyond protocol decision-making, a complex involving emotional cognitive work healthcare professionals We undertook realist review highlight understand interactions between different factors involved in deprescribing develop final programme theory that identifies explains components good practice support person-centred approach older patients with multimorbidity polypharmacy. Methods The involves identifying underlying causal mechanisms exploring how, under what conditions they work. conducted search electronic databases which were supplemented by citation checking consultation stakeholders identify other key documents. followed steps outlined Pawson et al. RAMESES standards syntheses. Results included 119 documents from data extracted produce context-mechanism-outcome configurations (CMOCs) theory. Our recognises is intervention influenced multitude factors. our include following: supportive infrastructure provides clear guidance around professional responsibilities enables multidisciplinary working continuity care, consistent access high-quality relevant patient contextual data, need creation shared explanation understanding meaning purpose trial learn space monitoring continuity. These development trust be managing uncertainty turn optimise outcomes. are summarised novel DExTruS framework. Conclusion findings recognise interpretive decision-making management needed best practice. have implications how we design consultations, training records/data management. also highlights role plays both as central element tailored prescribing potential outcome this area.

Language: Английский

Citations

Deprescribing Interventions among Community-Dwelling Older Adults: A Systematic Review of Economic Evaluations DOI

Sónia Romano, Débora Figueira, Inês Teixeira

et al.

PharmacoEconomics, Journal Year: 2021, Volume and Issue: 40(3), P. 269 - 295

Published: Dec. 16, 2021

Language: Английский

Citations

Barriers and enablers to deprescribing in long-term care facilities: a ‘best-fit’ framework synthesis of the qualitative evidence DOI

Clara H. Heinrich, Eoin Hurley, Suzanne McCarthy

et al.

Age and Ageing, Journal Year: 2021, Volume and Issue: 51(1)

Published: Nov. 16, 2021

older adults are at risk of adverse outcomes due to a high prevalence polypharmacy and potentially inappropriate medications (PIMs). Deprescribing interventions have been demonstrated reduce PIMs. However, deprescribing is not performed routinely in long-term care facilities (LTCFs). This qualitative evidence synthesis aims identify the factors which limit enable health workers' (HCWs) engagement with LTCFs.the 'best-fit' framework approach was used synthesise by using Theoretical Domains Framework (TDF) as priori framework. Included studies were analysed qualitatively LTCF barriers enablers mapped TDF. Constructs within domains refined best represent context. A conceptual model created, hypothesising relationships between enablers.of 655 records identified, 14 met inclusion criteria. The included 17 16 enablers, 11 TDF domains. perceptions an 'established hierarchy' LTCFs, negatively affecting communication insufficient resources limited HCWs' deprescribing. Enablers tailored guidelines, interprofessional support working patient focus, allowing patients' condition influence decisions.this study identified that education, collaboration can facilitate To overcome barriers, change required patient-centred HCWs need be equipped necessary adequate reimbursement. organisational structure must deprescribing, systems.

Language: Английский

Citations

The state of deprescribing research: How did we get here? DOI

Emily Reeve, Wade Thompson, Cynthia M. Boyd

et al.

Basic & Clinical Pharmacology & Toxicology, Journal Year: 2023, Volume and Issue: 133(6), P. 657 - 660

Published: March 28, 2023

Dr Reeve receives honoraria for co-authoring a chapter on deprescribing in UpToDate and honorarium from the Society of Hospital Pharmacists Australia (leading workshops deprescribing). Steinman authorship American Geriatrics service AGS Beers Criteria update panel. The authors have authored collaborated with several studies mentioned this commentary. This manuscript is based presentation given by at First International Conference Deprescribing (ICOD), Kolding, Denmark, September 2022.

Language: Английский

Citations

Deprescribing considerations for older people in general practice DOI

Hui Wen Quek, Amy Page,

Kathleen N. Potter

et al.

Australian Journal of General Practice, Journal Year: 2023, Volume and Issue: 52(4), P. 173 - 180

Published: April 1, 2023

Deprescribing is an integral part of patient care. The term 'deprescribing' may be new to some, but the concept not. refers planned withdrawal medicines that are causing harm or not helping individual.This article collates latest evidence on deprescribing guide general practitioners (GPs) and nurse how deprescribe for their elderly patients.Deprescribing a safe effective method reducing polypharmacy high-risk prescribing. challenge GPs in older people avoid adverse drug events. Strategies confidently partnership with patients include incorporating 'stop slow, go low' approach careful consideration medicine plan.

Language: Английский

Citations

MediQuit, an Electronic Deprescribing Tool for Patients on Polypharmacy: Results of a Feasibility Study in German General Practice DOI

Ulrike Junius‐Walker, Annika Viniol, Matthias Michiels‐Corsten

et al.

Drugs & Aging, Journal Year: 2021, Volume and Issue: 38(8), P. 725 - 733

Published: July 12, 2021

Deprescribing is an important task for general practitioners (GPs) in the face of risky polypharmacy. The electronic tool "MediQuit" was developed to guide GPs and patients through a deprescribing consultation that entails drug-selection phase, shared decision making, advice on safe implementation. A pilot study conducted determine target group selected assess impact, patient involvement, feasibility tool. This uncontrolled study. from two German regions were invited use MediQuit consultations with view one drug, if appropriate. They basis broad inclusion criteria. Collected data entailed participants' characteristics, patients' medication lists, deprescribed drugs, assessments. Patients contacted shortly after again 4 weeks. In total, 16 agreed participate, whom ten actually performed consultations. 41 predominately older excessive achieved 70% agreement patients. Drugs symptom-lowering preventive drugs (mainly anatomical therapeutic chemical classes C). found useful initiating communication this issue enhancing deliberations decision. median length 15 min (interquartile range 10–20). At follow-up, infrequently disagreed which drug(s) discontinued, rated involvement higher than did themselves. assists identifying concrete opportunities, making. three-step procedure well-accepted once initial organizational efforts are overcome. After revision, further studies needed enhance quality evidence acceptance effectiveness.

Language: Английский

Citations