Drugs & Aging, Journal Year: 2024, Volume and Issue: unknown
Published: Sept. 18, 2024
Language: Английский
npj Aging, Journal Year: 2024, Volume and Issue: 10(1)
Published: Jan. 23, 2024
Abstract Polypharmacy, commonly defined as ≥5 medications, is a rising public health concern due to its many risks of harm. One recommended strategy address polypharmacy medication reviews, with subsequent deprescription inappropriate medications. In this review, we explore the intersection older age, polypharmacy, and deprescribing in contemporary context by appraising published literature (2012–2022) identify articles that included new primary data on medications patients aged ≥65 years currently taking We found 31 were which describe current perceptions clinicians towards deprescribing, identified barriers, key enabling factors, future directions approaching deprescribing. Currently, believe complex process, despite majority reporting feeling comfortable fewer engage process regularly. Common barriers cited include lack knowledge training around time, breakdown communication, perceived ‘abandonment care’, fear adverse consequences, resistance from and/or their carers. factors recognition opportunities instigate regular improving lines education both multidisciplinary approach patient care. Addressing requires nuanced generally group patients. Key strategies reducing clinicians, addition communication between healthcare providers approach.
Language: Английский
Citations
20
Innovation in Aging, Journal Year: 2025, Volume and Issue: 9(2)
Published: Jan. 1, 2025
Polypharmacy, the concurrent use of multiple medicines, is a growing concern among older adults and those with chronic conditions. Deprescribing through dose reduction or discontinuing selected medicines strategy for reducing medicine-related harm. The Patient Typology was developed using qualitative methods to describe varying factors that are important when they consider deprescribing. objective this study quantitative define distinct classes via Typology. This used cross-sectional experimental design in which data collected an online survey from participants 65 years Australia, Netherlands, United Kingdom, States. A latent class analysis performed 4-item about beliefs importance how learn medicine decision-making preferences, attitudes towards stopping medicines. Older (n = 2,250) were median 70 2-thirds reported their highest level education associate's degree trade school less. We identified 4 classes: Class 1 "Trusts doctor" (41.6%), 2 "Makes own decisions" (30.2%), 3 "Avoids deprescribing" (15.5%), 'Medicines not important' (12.7%). report diverse perspectives deprescribing, emphasizing need tailored communication strategies clinical settings. Additional research needed examine adults' preferences real-world contexts refine improve deprescribing interventions. NCT04676282.
Language: Английский
Citations
2
Expert Review of Clinical Pharmacology, Journal Year: 2023, Volume and Issue: 16(5), P. 411 - 421
Published: March 30, 2023
Pharmacotherapy plays a critical role in the delivery of high-quality palliative care, but intersection care and deprescribing has received little attention.
Language: Английский
Citations
15
Journal of the American Medical Directors Association, Journal Year: 2024, Volume and Issue: 25(3), P. 439 - 447.e18
Published: Jan. 15, 2024
Language: Английский
Citations
5
Implementation Science, Journal Year: 2022, Volume and Issue: 17(1)
Published: Jan. 20, 2022
There is recognition that the overuse of procedures, testing, and medications constitutes low-value care which strains healthcare system and, in some circumstances, can cause unnecessary stress harm for patients. Initiatives across dozens countries have raised awareness about harms but had mixed success levels reductions realized been modest. Similar to complex drivers implementation processes, there a limited understanding individual social behavioral aspects de-implementation. While researchers begun use theory elucidate dynamics de-implementation, research remains largely atheoretical. The supports how why interventions succeed or fail what key factors predict success. purpose this scoping review was identify characterize theoretical approaches used understand and/or explain influences efforts reduce care.We conducted MEDLINE, EMBASE, CINAHL, Scopus databases from inception June 2021. Building on previous research, 43 terms were search literature. database searches identified 1998 unique articles titles abstracts screened inclusion; 232 items selected full-text review.Forty-eight studies met inclusion criteria. Over half included published last 2 years. Theoretical Domains Framework (TDF) most commonly determinant framework (n = 22). Of classic theories, majority Theory Planned Behavior 6). For Normalization Process COM-B 7). Theories frameworks primarily determinants 37) inform data analysis 31). Eleven types examined studies, with prescribing practices (e.g., overuse, polypharmacy, appropriate prescribing) targeted frequently.This provides rigorous, comprehensive, extensive synthesis influence care. results provide direction insight future primary support de-implementation reduction
Language: Английский
Citations
21
JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(10), P. e2337281 - e2337281
Published: Oct. 11, 2023
Little is known about why older adults decline deprescribing recommendations, primarily because interventional studies rarely capture the reasons.To examine factors important to who disagree with a recommendation given by primary care physician hypothetical patient experiencing polypharmacy.This online, vignette-based survey study was conducted from December 1, 2020, March 31, 2021, participants 65 years or in United Kingdom, US, Australia, and Netherlands. The outcome of main disagreement recommendation. A content analysis subsequently free-text reasons provided strongly disagreed deprescribing. Data were analyzed August 22, 2022, February 12, 2023.Attitudes, beliefs, fears, recommended actions response recommendations.Of 899 included analysis, mean (SD) age 71.5 (4.9) years; 456 (50.7%) men. Attitudes, fears reported doubts (361 [40.2%]), valuing medications (139 [15.5%]), preference avoid change (132 [14.7%]). Valuing more commonly among compared those (48 205 [23.4%] vs 91 694 [13.1%], respectively; P < .001) had personal experience same medication class as vignette no (93 517 [18.0%] 46 318 [12.1%], = .02). Participants shared that improved communication (225 [25.0%]), alternative strategies (138 [15.4%]), consideration preferences (137 [15.2%]) may increase their agreement interested additional (196 [28.2%] 29 [14.2%], .001), (117 [16.9%] 21 [10.2%], .02), (122 [17.6%] 15 [7.3%], .001).In this study, communication, strategies, disagreed. These findings suggest identifying degree could be used tailor patient-centered adults.
Language: Английский
Citations
11
Drugs & Aging, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 20, 2025
Language: Английский
Citations
0
Advanced clinical pharmacy - research, development and practical applications/Advanced clinical pharmacy - research, development and practical applications, Journal Year: 2025, Volume and Issue: unknown, P. 131 - 157
Published: Jan. 1, 2025
Language: Английский
Citations
0
British Journal of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: unknown
Published: Aug. 4, 2024
Abstract Deprescribing is an evidence‐based intervention to reduce potentially inappropriate medication use. Yet its implementation faces barriers including inadequate resources, training and time. Mobile applications (apps) on app stores could address some by offering educational content interactive features for assessment deprescribing guidance. A scoping review was undertaken examine existing apps, identifying artificial intelligence (AI) elements. comprehensive search conducted in August 2023 identify mobile apps with within the Apple Google Play Stores. The found were screened inclusion, data their extracted. Quality using App Rating Scale. Six deprescribing‐related identified: American Geriatrics Society Beers Criteria 2023, Dementia Training Australia Medications, Evidence‐Based Medicine Guide, Information Assessment Method Medical Guidelines, MedGPT‐Medical AI App, Polypharmacy: Manage Medicines. These focused primarily educating both patients/carers healthcare professionals about deprescribing. Amongst them, two included features, one incorporating technology. While these allowed queries input of patient‐level details, provided limited personalised advice. In terms quality, scored highly functionality information, poorly engagement aesthetics. This despite being educational, have limitations personalization user engagement. Future research should prioritize evaluating feasibility experience clinical settings, further explore how interactivity enhance usefulness practices.
Language: Английский
Citations
3
Age and Ageing, Journal Year: 2023, Volume and Issue: 52(1)
Published: Jan. 1, 2023
Abstract Background people living with cognitive impairment commonly take multiple medications including potentially inappropriate (PIMs), which puts them at risk of medication related harms. Aims to explore willingness have a deprescribed older (dementia or mild impairment) and chronic conditions assess the relationship between willingness, patient characteristics belief about medications. Methods cross-sectional study using results from revised Patients’ Attitudes Towards Deprescribing questionnaire (rPATDcog) collected as baseline data in OPTIMIZE study, pragmatic, cluster-randomised trial educating patients clinicians deprescribing. Eligible participants were 65+, diagnosed dementia impairment, prescribed least five-long-term Results was mailed 1,409 intervention 553 (39%) returned included analysis. Participants had mean age 80.1 (SD 7.4) 52.4% female. About 78.5% (431/549) said that they would be willing one their stopped if doctor it possible. Willingness deprescribe negatively associated getting stressed when changes are made previously having bad experience stopping (P < 0.001 for both). Conclusion most deprescribe. Addressing previous experiences stress may key points discuss during deprescribing conversations.
Language: Английский
Citations
7