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Limited By:	Subject = Deprescribing;

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Displaying Results 1 - 7 of 7 on page 1 of 1

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Adverse drug reactions and targets for deprescribing in high risk older adults (2018)

Lavan, Amanda H.

Adverse drug reactions and targets for deprescribing in high risk older adults (2018)

Lavan, Amanda H.

Abstract:

Over the last twenty years, many prescribing tools have been developed and validated to identify inappropriate prescribing (IP) in older adults and assist physicians in medication optimisation. However, these prescribing tools have predominantly focused on identifying IP in the general older adult population, rather than targeting the population cohort that is growing at the fastest rate and that is at the highest risk of IP and adverse drug reactions (ADRs) i.e. older frailer multimorbid patients with a poor survival prognosis. Extensive research on the prevalence of ADRs has been published. However many different definitions of ADRs and many different ADR causality tools have been employed across different studies, making it difficult to compare the results of studies. To confound this area of investigation further, many ADR causality tools are not appropriate to use in older frail multimorbid adults. In addition, a limited amount of research has occurred identifying the morbidity...

http://hdl.handle.net/10468/6800

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An exploration of deprescribing barriers and facilitators for older patients in primary care in Ireland – the potential role of the pharmacist (2019)

Hansen, Christina Raae

An exploration of deprescribing barriers and facilitators for older patients in primary care in Ireland – the potential role of the pharmacist (2019)

Hansen, Christina Raae

Abstract:

Introduction: The older population, often defined as people aged ≥ 65 years is growing. With older age, the risk of multimorbidity (commonly defined as the presence of ≥ 2 chronic conditions) increases together with the use of a high number of daily medicines or polypharmacy (≥ 5 daily medicines). These are two risk factors of poor health outcomes in older people, putting them at greater risk of experiencing potentially inappropriate prescribing (PIP), adverse drug events (ADEs) and poor quality of life (QoL). To reduce polypharmacy and the associated risk, the number of medications used per patient needs to be reduced by means of carefully considered deprescribing when appropriate. Deprescribing is the process of discontinuing inappropriate medications with the goal of optimising pharmacotherapy and improving health outcomes. Existing research is limited to support the effective and practical implementation of deprescribing. Pharmacists are trained to evaluate PIP and their knowled...

http://hdl.handle.net/10468/9544

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Challenges in deprescribing for young chronic benzodiazepine patients (2017)

Murphy, Kevin D.; Lambert, Sharon; McCarthy, Suzanne; Byrne, Stephen; Sahm, Laura J.

Challenges in deprescribing for young chronic benzodiazepine patients (2017)

Murphy, Kevin D.; Lambert, Sharon; McCarthy, Suzanne; Byrne, Stephen; Sahm, Laura J.

http://hdl.handle.net/10468/5886

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Deprescribing in multi-morbid older people with polypharmacy: agreement between STOPPFrail explicit criteria and gold standard deprescribing using 100 standardized clinical cases (2018)

Curtin, Denis; Dukelow, Tim; James, Kirstyn; O'Donnell, Desmond; O'Mahony, De...

Deprescribing in multi-morbid older people with polypharmacy: agreement between STOPPFrail explicit criteria and gold standard deprescribing using 100 standardized clinical cases (2018)

Curtin, Denis; Dukelow, Tim; James, Kirstyn; O'Donnell, Desmond; O'Mahony, Denis; Gallagher, Paul F.

Abstract:

Purpose: Older people with advanced frailty are among the highest consumers of medications. When life expectancy is limited, some of these medications are likely to be inappropriate. The aim of this study was to compare STOPPFrail, a concise, easy-to-use, deprescribing tool based on explicit criteria, with gold standard, systematic geriatrician-led deprescribing. Methods: One hundred standardized clinical cases involving 1024 medications were prepared. Clinical cases were based on anonymized hospitalized patients aged ≥ 65 years, with advanced frailty (Clinical Frailty Scale ≥ 6), receiving ≥ 5 regular medications, who were selected from a recent observational study. Level of agreement between deprescribing methods was measured by Cohen’s kappa coefficient. Sensitivity and positive predictive value of STOPPFrail-guided deprescribing relative to gold standard deprescribing was also measured. Results: Overall, 524 medications (51.2%) of medications prescribed to this frail, elderly co...

https://hdl.handle.net/10468/7152

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Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis (2018)

Raae Hansen, Christina; O'Mahony, Denis; Kearney, Patricia M.; Sahm, Laura J.; Cul...

Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis (2018)

Raae Hansen, Christina; O'Mahony, Denis; Kearney, Patricia M.; Sahm, Laura J.; Cullinan, Shane; Huibers, C. J. A.; Thevelin, Stefanie; Rutjes, Anne W. S.; Knol, Wilma; Streit, Sven; Byrne, Stephen

Abstract:

Aims: Deprescribing interventions safely and effectively optimize medication use in older people. However, questions remain about which components of interventions are key to effectively reduce inappropriate medication use. This systematic review examines the behaviour change techniques (BCTs) of deprescribing interventions and summarizes intervention effectiveness on medication use and inappropriate prescribing. Methods: MEDLINE, EMBASE, Web of Science and Academic Search Complete and grey literature were searched for relevant literature. Randomized controlled trials (RCTs) were included if they reported on interventions in people aged =65 years. The BCT taxonomy was used to identify BCTs frequently observed in deprescribing interventions. Effectiveness of interventions on inappropriate medication use was summarized in meta-analyses. Medication appropriateness was assessed in accordance with STOPP criteria, Beers' criteria and national or local guidelines. Between-study hetero...

http://hdl.handle.net/10468/7222

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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot (2018)

McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...

Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot (2018)

McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M.

Abstract:

Background: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care. Methods: This study is a cluster randomised controlled trial, involving 30 general practices and 450 patients throughout Ireland. Practices will be eligible to participate if they have at least 300 patients aged 65 years and over on their patient panel and if th...

http://hdl.handle.net/10379/12718

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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot. (2017)

McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...

Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot. (2017)

McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M

Abstract:

The original article is available at www.biomedcentral.com
Background: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care. Methods: This study is a cluster randomised controlled trial, involving 30 general practices a...

https://epubs.rcsi.ie/gpart/114

Displaying Results 1 - 7 of 7 on page 1 of 1