دورية أكاديمية
أعرض في EDS

Development of a deprescribing manual for frail older people for use in the COFRAIL study and in primary care.

التفاصيل البيبلوغرافية
العنوان: Development of a deprescribing manual for frail older people for use in the COFRAIL study and in primary care.
المؤلفون: Mann NK; Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany., Schmiedl S; Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; Philipp Klee-Institute for Clinical Pharmacology, Helios University Hospital Wuppertal, Wuppertal, Germany., Mortsiefer A; Institute of General Practice and Primary Care, Chair of General Practice II and Patient-Centredness in Primary Care, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Bencheva V; Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany., Löscher S; Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Ritzke M; Institute of General Practice, University Medical Center Rostock, Rostock, Germany., Drewelow E; Institute of General Practice, University Medical Center Rostock, Rostock, Germany., Feldmeier G; Institute of General Practice, University Medical Center Rostock, Rostock, Germany., Santos S; Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Wilm S; Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Thürmann PA; Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; Philipp Klee-Institute for Clinical Pharmacology, Helios University Hospital Wuppertal, Wuppertal, Germany.
مؤلفون مشاركون: COFRAIL study group
المصدر: Therapeutic advances in drug safety [Ther Adv Drug Saf] 2022 Sep 06; Vol. 13, pp. 20420986221122684. Date of Electronic Publication: 2022 Sep 06 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: SAGE Publications Country of Publication: England NLM ID: 101549074 Publication Model: eCollection Cited Medium: Print ISSN: 2042-0986 (Print) Linking ISSN: 20420986 NLM ISO Abbreviation: Ther Adv Drug Saf Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: London : SAGE Publications
مستخلص: Introduction: Many older adults are affected by multimorbidity and subsequent polypharmacy which is associated with adverse outcomes. This is especially relevant for frail older patients. Polypharmacy may be reduced via deprescribing. As part of the complex intervention in the COFRAIL study, we developed a deprescribing manual to be used by general practitioners (GPs) in family conferences, in which GPs, patients and caregivers jointly discuss treatments.
Methods: We selected indications with a high prevalence in older adults in primary care (e.g. diabetes mellitus, hypertension) and conducted a literature search to identify deprescribing criteria for these indications. We additionally reviewed clinical practice guidelines. Based on the extracted information, we created a deprescribing manual which was then piloted in an expert workshop and in family conferences with volunteer patients according to the inclusion and exclusion criteria of the study protocol.
Results: Initially, 13 indications/topics were selected. The literature search identified deprescribing guides, reviews and clinical trials as well as lists of potentially inappropriate medication and systematic reviews on the risk and benefits of specific drugs and drug classes in older patients. After piloting and revisions, the deprescribing manual now covers 11 indications/topics. In each chapter, patient- and medication-related deprescribing criteria, monitoring and communication strategies, and information about concerns related to the use of specific drugs in older patients are provided.
Discussion: We found varying deprescribing strategies in the literature, which we consolidated in our deprescribing manual. Whether this approach leads to successful deprescribing in family conferences is being investigated in the cluster-randomised controlled COFRAIL study.
Plain Language Summary: Development of a manual to help doctors to identify which medications can be withdrawn Many older adults suffer from chronic diseases and take multiple medications concurrently. This can lead to side effects and other undesired events. We developed a manual to help doctors identify which medications can be withdrawn, so that they can discuss this with their patients. This manual was used in the COFRAIL study where doctors, patients and caregivers met in family conferences to discuss their preferences and decide together how future treatments should be handled. The manual contains information on common medications, symptoms and diseases in older patients such as diabetes and high blood pressure. Before the manual was used in the study, it was tested by volunteer patients and their doctors and caregivers to make sure that it is user-friendly.
Competing Interests: Competing interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
(© The Author(s), 2022.)
References: Expert Opin Drug Saf. 2018 Dec;17(12):1185-1196. (PMID: 30540223)
Trials. 2020 Mar 20;21(1):285. (PMID: 32197631)
Cochrane Database Syst Rev. 2018 Sep 03;9:CD008165. (PMID: 30175841)
J Am Geriatr Soc. 2015 Nov;63(11):2227-46. (PMID: 26446832)
Dtsch Arztebl Int. 2010 Aug;107(31-32):543-51. (PMID: 20827352)
PLoS One. 2016 Mar 04;11(3):e0149984. (PMID: 26942907)
J Am Geriatr Soc. 2019 Jan;67(1):172-180. (PMID: 30315745)
PLoS One. 2015 Apr 07;10(4):e0122246. (PMID: 25849568)
Drugs Aging. 2008;25(12):1021-31. (PMID: 19021301)
J Gerontol A Biol Sci Med Sci. 2022 May 5;77(5):1020-1034. (PMID: 34390339)
J Am Geriatr Soc. 2008 Oct;56(10):1946-52. (PMID: 18771457)
Br J Gen Pract. 2018 Oct;68(675):e663-e672. (PMID: 30249607)
Can Fam Physician. 2018 Jan;64(1):17-27. (PMID: 29358245)
PEC Innov. 2022 Mar 24;1:100032. (PMID: 37213749)
Diabetes Ther. 2017 Feb;8(1):23-31. (PMID: 27981503)
CMAJ. 2005 Aug 30;173(5):489-95. (PMID: 16129869)
J Clin Epidemiol. 2020 Nov;127:87-95. (PMID: 32707072)
Can Fam Physician. 2017 May;63(5):354-364. (PMID: 28500192)
Res Social Adm Pharm. 2019 Jun;15(6):806-810. (PMID: 30241877)
BMC Geriatr. 2017 Oct 16;17(Suppl 1):225. (PMID: 29047342)
Ther Adv Drug Saf. 2018 Jan;9(1):25-43. (PMID: 29318004)
Isr Med Assoc J. 2007 Jun;9(6):430-4. (PMID: 17642388)
Implement Sci. 2008 Oct 27;3:45. (PMID: 18954465)
BMC Public Health. 2011 Feb 14;11:101. (PMID: 21320345)
Circ Res. 2019 Mar 29;124(7):1045-1060. (PMID: 30920928)
Br J Clin Pharmacol. 2015 Dec;80(6):1254-68. (PMID: 27006985)
BMC Geriatr. 2017 Oct 10;17(1):230. (PMID: 29017448)
Br J Clin Pharmacol. 2014 Oct;78(4):738-47. (PMID: 24661192)
PLoS One. 2016 Aug 12;11(8):e0161248. (PMID: 27517450)
JAMA Intern Med. 2015 May;175(5):827-34. (PMID: 25798731)
Eur Heart J. 2018 Sep 1;39(33):3021-3104. (PMID: 30165516)
Eur J Clin Pharmacol. 2015 Jul;71(7):861-75. (PMID: 25967540)
Arch Intern Med. 2010 Oct 11;170(18):1648-54. (PMID: 20937924)
BJGP Open. 2020 Aug 25;4(3):. (PMID: 32723784)
Can Fam Physician. 2017 Nov;63(11):832-843. (PMID: 29138153)
Can Fam Physician. 2018 May;64(5):339-351. (PMID: 29760253)
Br J Clin Pharmacol. 2015 Oct;80(4):796-807. (PMID: 25619317)
Eur J Clin Pharmacol. 2018 Jun;74(6):679-700. (PMID: 29589066)
Eur J Intern Med. 2017 Mar;38:3-11. (PMID: 28063660)
PLoS One. 2016 Apr 19;11(4):e0151066. (PMID: 27093289)
Ann Intern Med. 2003 Sep 16;139(6):493-8. (PMID: 13679327)
J Am Med Dir Assoc. 2020 Feb;21(2):181-187. (PMID: 31926797)
فهرسة مساهمة: Keywords: deprescribing; family conferences; older patients; polypharmacy
تواريخ الأحداث: Date Created: 20220912 Latest Revision: 20240903
رمز التحديث: 20240903
مُعرف محوري في PubMed: PMC9452796
DOI: 10.1177/20420986221122684
PMID: 36091625
قاعدة البيانات: MEDLINE
الوصف
تدمد:2042-0986
DOI:10.1177/20420986221122684