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Implementation considerations of deprescribing interventions: A scoping review.
Wang, Jinjiao; Shen, Jenny Y; Conwell, Yeates; Podsiadly, Eric J; Caprio, Thomas V; Nathan, Kobi; Yu, Fang; Ramsdale, Erika E; Fick, Donna M; Mixon, Amanda S; Simmons, Sandra F.
Afiliación
  • Wang J; Elaine, Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester, Rochester, New York, USA.
  • Shen JY; Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA.
  • Conwell Y; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
  • Podsiadly EJ; Harriet J. Kitzman Center for Research Support, School of Nursing, University of Rochester, Rochester, New York, USA.
  • Caprio TV; Department of Medicine, Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA.
  • Nathan K; UR Medicine Home Care, University of Rochester Medical Center, Rochester, New York, USA.
  • Yu F; University of Rochester Medical Center, Finger Lakes Geriatric Education Center, Rochester, New York, USA.
  • Ramsdale EE; Department of Medicine, Division of Geriatrics & Aging, University of Rochester Medical Center, Rochester, New York, USA.
  • Fick DM; St. John Fisher College, Wegmans School of Pharmacy, Rochester, New York, USA.
  • Mixon AS; Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.
  • Simmons SF; Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, New York, USA.
J Intern Med ; 2022 Dec 16.
Article en En | MEDLINE | ID: mdl-36524602
Over half of older adults experience polypharmacy, including medications that may be inappropriate or unnecessary. Deprescribing, which is the process of discontinuing or reducing inappropriate and/or unnecessary medications, is an effective way to reduce polypharmacy. This review summarizes (1) the process of deprescribing and conceptual models and tools that have been developed to facilitate deprescribing, (2) barriers, enablers, and factors associated with deprescribing, and (3) characteristics of deprescribing interventions in completed trials, as well as (4) implementation considerations for deprescribing in routine practice. In conceptual models of deprescribing, multilevel factors of the patient, clinician, and health-care system are all related to the efficacy of deprescribing. Numerous tools have been developed for clinicians to facilitate deprescribing, yet most require substantial time and, thus, may be difficult to implement during routine health-care encounters. Multiple deprescribing interventions have been evaluated, which mostly include one or more of the following components: patient education, medication review, identification of deprescribing targets, and patient and/or provider communication about high-risk medications. Yet, there has been limited consideration of implementation factors in prior deprescribing interventions, especially with regard to the personnel and resources in existing health-care systems and the feasibility of incorporating components of deprescribing interventions into the routine care processes of clinicians. Future trials require a more balanced consideration of both effectiveness and implementation when designing deprescribing interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Systematic_reviews Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Systematic_reviews Idioma: En Revista: J Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido