Critical Care Nursing Clinics of North America, Год журнала: 2023, Номер 35(4), С. 505 - 512
Опубликована: Июль 1, 2023
Язык: Английский
Medical Science Educator, Год журнала: 2023, Номер 33(2), С. 551 - 567
Опубликована: Фев. 23, 2023
Deprescribing involves reducing or stopping medications that are causing more harm than good no longer needed. It is an important approach to managing polypharmacy, yet healthcare professionals identify many barriers. We present a proposed pre-licensure competency framework describes essential knowledge, teaching strategies, and assessment protocols promote interprofessional deprescribing skills. The considers how involve patients care partners in decisions. An action plan example curriculum mapping exercise included help educators assess their curricula, select implement these concepts strategies within programs ensure learners graduate with competencies manage increasingly complex medication regimens as people age.The online version contains supplementary material available at 10.1007/s40670-022-01704-9.
Язык: Английский
Процитировано
26
International Journal of General Medicine, Год журнала: 2021, Номер Volume 14, С. 3793 - 3807
Опубликована: Июль 1, 2021
Abstract: Polypharmacy is a major challenge in healthcare for older people, and associated with increased risks of adverse outcomes, such as delirium, falls, frailty, cognitive impairment hospitalization. There significant public professional interest the role deprescribing reducing medication-related harms people. We aim to provide narrative review 1) safety efficacy interventions, 2) challenges solutions research implementation clinical practice, 3) benefits using Computerized Clinical Decision Support Systems (CCDSS) Quality Indicators (QIs) practice. Deprescribing an established management strategy minimize polypharmacy potentially inappropriate medications. limited evidence its on global geriatric outcomes. Various at patient, system levels may impact success interventions Management strategies that target all are required overcome these challenges. Future studies consider large multicenter prospective designs establish effects sustainability Keywords: deprescribing, polypharmacy, geriatric, computerized decision support, quality indicator
Язык: Английский
Процитировано
55
European Geriatric Medicine, Год журнала: 2022, Номер 13(3), С. 513 - 528
Опубликована: Янв. 1, 2022
Abstract Purpose The world’s population is ageing. Therefore, every doctor should receive geriatric medicine training during their undergraduate education. This review aims to summarise recent developments in that will potentially inform and updating of medical curricula for content. Methods We systematically searched the electronic databases Ovid Medline, Embase Pubmed, from 1st January 2009 18th May 2021. included studies related (1) students (2) or ageing older adults (3) curriculum topics learning objectives competencies teaching methods students’ attitudes (4) published a scientific journal. No language restrictions were applied. Results identified 2503 records assessed full texts 393 eligibility with 367 thematic analysis. Six major themes emerged: curriculum, topics, methods, settings, skills attitudes. New focussed on minimum Geriatrics Competencies, Geriatric Psychiatry Comprehensive Assessment; vertical integration Medicine into has been advocated. Emerging evolving delirium, pharmacotherapeutics, healthy health promotion, Telemedicine. Teaching emphasised interprofessional education, senior mentor programmes intergenerational contact, student journaling reflective writing, simulation, clinical placements e-learning. Nursing homes featured among new settings. Communication skills, empathy professionalism highlighted as essential interacting adults. Conclusion recommend future take account described this paper. In addition including newly emerged advances existing different settings also be considered. Employing throughout course can usefully supplement achieved dedicated course. Interprofessional education improve understanding roles other professionals team-working skills. A focus improving communication particularly enable better interaction patients. Embedding expected levels ensure have acquired necessary effectively treat
Язык: Английский
Процитировано
31
European Geriatric Medicine, Год журнала: 2023, Номер 14(6), С. 1195 - 1209
Опубликована: Окт. 9, 2023
Abstract Inappropriate polypharmacy is highly prevalent among older adults and presents a significant healthcare concern. Conducting medication reviews implementing deprescribing strategies in multimorbid with are an inherently complex challenging task. Recognizing this, the Special Interest Group on Pharmacology of European Geriatric Medicine Society has compiled evidence review formulated recommendations to enhance appropriate prescribing practices. The current supports need for comprehensive widespread transformation education, guidelines, research, advocacy, policy improve management individuals. Furthermore, incorporating as routine aspect care ageing population crucial. We emphasize importance involving geriatricians experts geriatric pharmacology driving, actively participating this transformative process. By doing so, we can work towards achieving optimal use enhancing well-being generations come.
Язык: Английский
Процитировано
16
British Journal of Clinical Pharmacology, Год журнала: 2022, Номер 89(2), С. 687 - 698
Опубликована: Авг. 30, 2022
The drug burden index (DBI) measures a person's total exposure to anticholinergic and sedative medications, which are commonly associated with harm. Through incorporating the DBI in electronic medical records (eMR) implementing stewardship program, we aimed determine (i) uptake of steward's recommendations deprescribe and/or drugs by team (ii) whether accepted were actioned hospital or recommended for follow-up General Practitioner post-discharge.
Язык: Английский
Процитировано
20
British Journal of Clinical Pharmacology, Год журнала: 2025, Номер unknown
Опубликована: Март 24, 2025
Deprescribing is complex because it involves patients' health, values, and preferences. The World Health Organization Canadian Medication Appropriateness Network have recommended that deprescribing be integrated into health curricula, prompting the need for further understanding about education. purpose of this research to describe literature regarding education provided healthcare professionals. We conducted a scoping review using five-step model by Arksey O'Malley with revisions from Levac et al. databases searched included Medline, Scopus, Embase ERIC. Papers were if they written in English contained an educational intervention tailored toward physicians, pharmacists or nurses. White papers conference abstracts included. A total 4853 eligible screening 46 (25 full texts, 15 6 white papers). Thirty-three utilized group their these, 20 involved interactive portions. Medicine was most targeted profession, 29 papers. common outcomes number medications deprescribed increase learner knowledge self-efficacy self-assessment surveys post-educational examinations. found there evidence interventions can participant improve self-efficacy. To expand deprescribing, future should engage utilize variety professions could include real patients. Further required determine retention application gained single interventions.
Язык: Английский
Процитировано
0
Research in Social and Administrative Pharmacy, Год журнала: 2021, Номер 18(8), С. 3350 - 3357
Опубликована: Дек. 5, 2021
Язык: Английский
Процитировано
20
Drugs & Aging, Год журнала: 2023, Номер 40(7), С. 633 - 642
Опубликована: Май 9, 2023
Implementation of the Drug Burden Index (DBI) as a risk assessment tool in clinical practice may facilitate deprescribing. The purpose this study is to evaluate how comprehensive intervention bundle using DBI impacts (i) proportion older inpatients with at least one DBI-contributing medication stopped or dose reduced on discharge, compared admission; and (ii) changes deprescribing different classes during hospitalisation. This before-and-after was conducted an Australian metropolitan tertiary referral hospital. Patients aged ≥ 75 years admitted acute care service for 48 h from December 2020 October 2021 prescribed were included. During control period, usual provided. intervention, access added, including clinician interface displaying score electronic medical record. In subsequent 'stewardship' stewardship pharmacist used provide clinicians patient-specific recommendations medications. Overall, 457 hospitalisations patients stopped/reduced discharge increased 29.9% (control period) 37.5% [intervention; adjusted difference (aRD) 6.5%, 95% confidence intervals (CI) −3.2 17.5%] 43.1% (stewardship; aRD 12.1%, CI 1.0–24.0%). opioid prescriptions rose 17.9% 45.7% (p = 0.04). Integrating accompanying program promising strategy sedative anticholinergic medications inpatients.
Язык: Английский
Процитировано
7
BMC Palliative Care, Год журнала: 2024, Номер 23(1)
Опубликована: Сен. 6, 2024
Язык: Английский
Процитировано
2
Life and Medical Sciences, Год журнала: 2023, Номер unknown
Опубликована: Апрель 5, 2023
The term polypharmacy is generally known as the simultaneous use of five or more medicines. An increase in also observed with chronic diseases, which increases age. main complications are medicine side effects, inappropriate use, drug-drug interaction, and drug-disease interactions. Family physicians most effective physician group coordinating therapy, they provide continuous, longitudinal, comprehensive medical care to individual. In this study, it was aimed determine need an auxiliary web application regarding family residents' awareness effects geriatric population identify barriers rational drug their daily clinical practice. research a cross-sectional observational all residents actively working Ankara City Hospital Medicine Clinic were planned be included invited study. study conducted through survey method under observation. It determined that patients mostly referred "clinical experience" according participants. obstacles faced by participants "not having enough knowledge" "patient-centered regulation difficult time consuming". 75.3% respondents (n=70) marked strongly agree 18.3% (n=17) for statement "I would like have easily accessible artificial intelligence aided I can my practice such interactions, drug-chronic disease incompatibility, potentially (PIM) elderly" mean value proposition 4.65±0.7. This showed resources used detect its not adequately appropriately. Moreover, results present demand time-saving facilitating applications minimize PIM, interaction elderly evaluate light current data person-centered clinician's
Язык: Английский
Процитировано
4