Journal of Geriatric Oncology, Год журнала: 2024, Номер 15(5), С. 101760 - 101760
Опубликована: Март 30, 2024
Язык: Английский
Supportive Care in Cancer, Год журнала: 2025, Номер 33(4)
Опубликована: Март 26, 2025
Abstract Purpose This study aimed to determine the prevalence of potentially inappropriate medications (PIMs) among adult cancer patients in palliative care, rate at which physicians implemented pharmacists’ deprescribing recommendations, and some cost implications deprescribing. Methods Medication reconciliation was performed for each eligible patient, with both OncPal guideline clinical judgement applied identify PIMs. PIM evaluated medication class. The physician recommendation implementation savings were calculated. Results In 48 included patients, 25.2% PIMs (mean 2.4/patient) - 86.7% OncPal-defined PIMs, most commonly vitamins, gastro-oesophageal reflux disease (GORD), lipid-modifying agents. Pharmacist recommendations 71.7% time, equivalent 1.7 fewer per patient. 28-day €948.27 deprescribed Implementation rates varied based on patient admission type, a significantly higher ( p <0.05) those admitted end-of-life care (83.3%) versus symptom control (65.1%) respite (30%) admissions. Recommendations deprescribe GORD had lower (26.7%) compared all other <0.0001). Conclusion underscores benefits pharmacist-led inpatient resulting reduced burden. There is notable need proactive before reaching care. Different across types highlight significance reviewing may have role management. omission from emphasises importance refining future guidelines
Язык: Английский
Процитировано
0
Oxford University Press eBooks, Год журнала: 2025, Номер unknown, С. 373 - 384
Опубликована: Март 1, 2025
Abstract ‘Pharmacology and Therapeutics’ comprises nine cases which cover essential relevant pharmacokinetics pharmacodynamics, important iatrogenic conditions arise in the palliative care population, drug-management of nausea according to established receptor model. It also discusses unique pharmacology methadone its use pain, examines wider medicine management issues, including polypharmacy, deprescribing, driving on prescription drugs. Life-threatening drug-induced clinical presentations, their pathophysiology, diagnosis, are reviewed detail. Prescribing considerations renal impairment hepatic failure examined – considering how drug absorption, distribution, metabolism excretion alter those with organ dysfunction. The role Cytochrome P450 enzymes is discussed, along mechanisms common interactions potential consequences medicine.
Язык: Английский
Процитировано
0
Current Hypertension Reports, Год журнала: 2022, Номер 24(11), С. 571 - 580
Опубликована: Июль 26, 2022
Abstract Purpose of Review To summarise evidence on both appropriate and inappropriate antihypertensive drug withdrawal. Recent Findings Deprescribing should be attempted in the following steps: (1) identify patients with several comorbidities significant functional decline, i.e. people at higher risk for negative outcomes related to polypharmacy lower blood pressure; (2) check (3) candidate drugs deprescribing; (4) withdraw medications 4-week intervals; (5) monitor pressure adverse events. Although is accumulating regarding short-term deprescribing, long-term effects remain unclear. Summary The limited deprescribing means that it not routinely attempted, unless response specific events or discussions between physicians about uncertain benefits harms treatment. Perspectives Clinical controlled trials are needed examine older subjects, especially those comorbidities, decline.
Язык: Английский
Процитировано
18
Life, Год журнала: 2022, Номер 12(5), С. 613 - 613
Опубликована: Апрель 20, 2022
The aim of palliative care is to maintain as high a quality life (QoL) possible despite life-threatening illness. Thus, the prescribed medications need be evaluated and benefit each treatment must weighed against potential side effects. Medications that contribute symptom relief maintained QoL should prioritized. However, studies have shown with preventive drugs may not patient in end-of-life generally deprescribed very late disease trajectory cancer patients. Yet, knowing how when deprescribe can difficult. In addition, some drugs, such beta-blockers, proton pump inhibitors, anti-depressants cortisone scaled down slowly avoid troublesome withdrawal symptoms. contrast, other medicines, statins, antihypertensives vitamins, discontinued directly. this review give advice according current evidence clinical praxis. includes antihypertensive anti-coagulants, aspirin, anti-diabetics, histamin-2-blockers, bisphosphonates denosumab, urologicals, anti-depressants, cortisone, thyroxin vitamins.
Язык: Английский
Процитировано
16
Journal of Geriatric Oncology, Год журнала: 2024, Номер 15(5), С. 101760 - 101760
Опубликована: Март 30, 2024
Язык: Английский
Процитировано
3