British Journal of Clinical Pharmacology,
Год журнала:
2021,
Номер
88(2), С. 452 - 463
Опубликована: Июнь 22, 2021
Community-based
pharmacists
are
an
important
stakeholder
in
providing
continuing
care
for
chronic
multi-morbid
patients,
and
their
role
is
steadily
expanding.
The
aim
of
this
study
to
examine
the
literature
exploring
community-based
pharmacist-initiated
and/or
-led
deprescribing
evaluate
impact
on
success
clinical
outcomes.Library
trials
databases
were
searched
from
inception
March
2020.
Studies
included
if
they
explored
adults,
by
available
English.
Two
reviewers
extracted
data
independently
using
a
pre-agreed
extraction
template.
Meta-analysis
was
not
performed
due
heterogeneity
designs,
types
intervention
outcomes.A
total
24
studies
review.
Results
grouped
based
method
into
four
categories:
educational
interventions;
interventions
involving
medication
review,
consultation
or
therapy
management;
pre-defined
pharmacist-led
collaborative
interventions.
All
resulted
greater
discontinuation
medications
comparison
usual
care.
Educational
reported
financial
benefits
as
well.
Medication
review
pharmacist
can
lead
successful
high-risk
medication,
but
do
affect
risk
rate
falls,
hospitalisations,
mortality
quality
life.
Pharmacist-led
patients
with
mental
illness,
resulting
improves
anticholinergic
side
effects,
memory
Pre-defined
did
reduce
healthcare
resource
consumptions
contribute
savings.
Short
follow-up
periods
prevent
evaluation
long-term
sustainability
interventions.This
systematic
suggests
that
valuable
partners
collaborations,
necessary
monitoring
throughout
tapering
post-follow-up
ensure
intervention.
BMJ Open,
Год журнала:
2025,
Номер
15(1), С. e095584 - e095584
Опубликована: Янв. 1, 2025
Objective
To
map
instruments
for
assessing
healthcare
professionals’
knowledge,
attitudes
and
practices
regarding
deprescribing.
Introduction
Deprescribing
is
essential
improving
patient
outcomes
by
managing
polypharmacy,
reducing
fall
risks
decreasing
medication
costs.
However,
there
a
limited
exploration
of
perspectives
about
Methods
analysis
Studies
involving
professionals
directly
involved
in
the
use
process
(nurses,
pharmacists
physicians)
will
be
included,
while
those
which
it
not
possible
to
identify
professional
excluded.
Any
definition
deprescribing,
as
well
any
stage
deprescribing
process,
without
clear
employing
whether
validated
or
not,
included.
focusing
on
algorithms
setting
Data
presented
absolute
relative
frequencies,
world
heatmap,
heatmaps,
bar
plots
word
cloud
when
appropriate.
Ethics
dissemination
The
findings
from
this
review
discussed
with
stakeholders
processes.
Additionally,
results
disseminated
through
publications
conference
presentations.
Protocol
registration
https://osf.io/tgjyc/
Journal of Clinical Pharmacy and Therapeutics,
Год журнала:
2018,
Номер
43(4), С. 550 - 555
Опубликована: Апрель 22, 2018
What
is
known
and
objective
Deprescribing
the
process
of
discontinuing
or
reducing
dosage
medications
that
are
no
longer
appropriate
aligned
with
goals
care,
which
paramount
in
elderly
patients
multiple
comorbidities
polypharmacy.
The
this
study
was
to
assess
perceptions
primary
care
physicians
on
deprescribing
for
potential
barriers
experience
Local
Health
Authority
(LHA)
Parma,
Emilia-Romagna,
Italy.
Methods
One
hundred
sixty
(57%
total
number
Parma)
attended
an
educational
session
related
were
asked
anonymously
complete
a
paper
survey.
Participants
their
level
agreement
nine
questions
about
perception
factors
affecting
using
seven-point
Likert-type
scale.
A
correlation
coefficient
calculated
association
between
physicians'
confidence
attitudes
associated
deprescribing.
Results
discussion
Many
(72%)
reported
general
ability
deprescribe.
Most
respondents
(78%)
they
comfortable
preventive
medications,
yet
only
half
(53%)
guideline-recommended
therapies.
Lack
evidence
medicines
concern
withdrawal
side
effects
impede
by
more
than
one-third
physicians.
When
initially
prescribed
another
physician,
40%
hesitance
them.
About
(45%)
did
not
feel
when
patients/caregivers
believed
continuation
medication
needed.
time
difficulty
engaging
cited
as
one
four
There
strong
new
conclusion
results
show
believe
generally
deprescribing,
although
there
still
several
hamper
engage
process.
An
improved
understanding
views
may
help
guide
further
research,
policies
remain
healthy
while
streamlining
regimen.
Palliative Medicine,
Год журнала:
2018,
Номер
33(1), С. 37 - 48
Опубликована: Сен. 19, 2018
Knowing
the
barriers/enablers
to
deprescribing
in
people
with
a
life-limiting
disease
is
crucial
for
development
of
successful
interventions.
These
have
been
studied,
but
available
evidence
has
not
summarized
systematic
review.To
identify
medications
disease.Systematic
review,
registered
PROSPERO
(CRD42017073693).A
search
MEDLINE,
Embase,
Web
Science
and
CENTRAL
was
conducted
extended
hand
search.
Peer-reviewed,
primary
studies
reporting
on
context
explicit
were
included
this
review.A
total
1026
references
checked.
Five
met
criteria
review.
Three
types
found:
organizational,
professional
patient
(family)-related
barriers/enablers.
The
most
prominent
enablers
organizational
support
(e.g.
standardized
medication
review),
involvement
multidisciplinary
teams
review
perception
importance
coming
joint
decision
regarding
deprescribing,
which
highlighted
need
interdisciplinary
collaboration
involving
his
family
decision-making
process.
important
barriers
shortages
staff
perceived
difficulty
or
resistance
nursing
home
resident's
-
resident
himself.The
scarcity
findings
literature
highlights
filling
gap.
Further
research
should
focus
deepening
knowledge
these
order
develop
sustainable
multifaceted
interventions
palliative
care.
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
Drugs & Aging,
Год журнала:
2022,
Номер
39(3), С. 209 - 221
Опубликована: Фев. 21, 2022
Benefits
and
risks
of
preventive
medication
change
over
time
for
ageing
patients
deprescribing
may
be
needed.
Deprescribing
cardiovascular
antidiabetic
drugs
can
challenging
is
not
widely
implemented
in
daily
practice.The
aim
this
study
was
to
identify
barriers
enablers
cardiometabolic
as
seen
by
healthcare
providers
(HCPs)
different
disciplines,
explore
their
views
on
specific
roles
the
process
deprescribing.Three
focus
groups
with
five
general
practitioners,
eight
pharmacists,
three
nurse
two
geriatricians,
elder
care
physicians
were
conducted
cities
The
Netherlands.
Interviews
recorded
transcribed
verbatim.
Directed
content
analysis
performed
basis
Theoretical
Domains
Framework.
Two
researchers
independently
coded
data.Most
HCPs
agreed
that
relevant
but
include
lack
evidence
expertise,
negative
beliefs
fears,
poor
communication
collaboration
between
HCPs,
resources.
Having
a
guideline
considered
an
enabler
medication.
Some
feared
consequences
discontinuing
or
medication,
while
others
motivated
deprescribe
when
experienced
no
problems
all
disciplines
stated
adequate
patient
involving
relatives
decision
making
enables
deprescribing.
Barriers
included
use
initiated
specialists,
exchange
information,
amount
it
takes
uncertain
about
each
other's
responsibilities.
A
multidisciplinary
approach
including
pharmacist
practitioner
best
way
support
address
related
resources.HCPs
recognized
importance
medical
only
made
close
cooperation
patient.
To
successfully
accomplish
they
strongly
recommended
approach.
The Journals of Gerontology Series A,
Год журнала:
2023,
Номер
78(9), С. 1692 - 1700
Опубликована: Янв. 24, 2023
Polypharmacy
is
associated
with
poor
outcomes
in
older
adults.
Targeted
deprescribing
of
anticholinergic
and
sedative
medications
may
improve
health
for
frail
Our
pharmacist-led
intervention
was
a
pragmatic
2-arm
randomized
controlled
trial
stratified
by
frailty.
We
compared
usual
care
(control)
the
pharmacists
providing
recommendations
to
general
practitioners.
