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Abstract

DEPRESCRIBING: IMPROVES HEALTH OUTCOME IN GERIATRIC

Satish S. and Charutha Reji*

Abstract

Deprescribing goals to manage polypharmacy and improves outcomes Common goals for deprescribing include reducing overall medication burden, reducing the risk of specific geriatric syndromes such as falls and cognitive impairment, and improving global health outcomes such as hospitalization and death. Patient characteristics which are good targets for deprescribing efforts include polypharmacy, multimorbidity, renal impairment, transitions of care, medication nonadherence, limited life expectancy, older age, frailty, and dementia. Multiple steps are necessary to ensure that the process is patient-centered and achieves the best possible outcomes. Patient characteristics which are good targets for deprescribing efforts include polypharmacy, multimorbidity, renal impairment, transitions of care, medication nonadherence, limited life expectancy, older age, frailty, and dementia. Tapering is a good strategy for many medications. It can reduce the chance of adverse drug withdrawal events (ADWEs), facilitate identification of the lowest effective dose in patients who are unable to stop a drug completely, and support long-term drug cessation by increasing patient comfort and willingness to try deprescribing. Several common barriers to deprescribing such as patient reluctance, care shared between multiple providers, challenges in recognizing appropriate medications, and clinical inertia can be addressed through communication, education, and other strategies. Large variety of resources and tools that have been developed to support health care professionals to deprescribe, such as generic frameworks and drug-specific deprescribing guidelines. In conclusion deprescribing has been shown to reduce potentially inappropriate or unnecessary medications; however, whether these benefits translate into improved quality of life (QOL) is uncertain.

Keywords: Deprescribing, polypharmacy.


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