Literature DB >> 27651709

Deprescription: The prescription metabolism.

Gurusamy Sivagnanam1.   

Abstract

Deprescribing is a structured approach to drug discontinuation. An alternative suggested term is "prescription metabolism." The major aim of deprescription is to purge the drug(s) considered unwanted in a given patient, especially in the elderly patients with multiple comorbidities or in those suffering from chronic disease. Like drug metabolism, prescription metabolism is a way of eliminating unwanted, troublesome, or cost-ineffective medications. The removal of such drugs has been found to decrease the incidence of adverse drug reactions and improves the rate of medication adherence, thereby reducing the economic burden on the patient as well as on the health care providers. Certain categories of drugs are to be tapered rather than abruptly stopped. Despite the availability of many tools to minimize drug therapy-related problems, there is little guidance for the process of deprescribing in general clinical practice. Various methods to reduce the risks of polypharmacy include patient education, physician education, and regulatory intervention. The suggested S and S approach (seek and screen, save and severe, sensitize and supervise) may be tried for deprescribing in general practice. More research on deprescribing is the need of the hour in almost all branches of clinical medicine which may pave the way for the betterment of health care.

Entities:  

Keywords:  Discontinuation; pharmacolysis; prescription pruning; untrials; withdrawal

Year:  2016        PMID: 27651709      PMCID: PMC5020772          DOI: 10.4103/0976-500X.189680

Source DB:  PubMed          Journal:  J Pharmacol Pharmacother        ISSN: 0976-500X


  21 in total

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Journal:  Am J Med       Date:  2012-03-03       Impact factor: 4.965

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Authors:  Remo Ostini; Claire Jackson; Desley Hegney; Susan E Tett
Journal:  Med Care       Date:  2011-01       Impact factor: 2.983

5.  Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy.

Authors:  Doron Garfinkel; Derelie Mangin
Journal:  Arch Intern Med       Date:  2010-10-11

6.  Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin.

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Journal:  Circulation       Date:  2004-10-11       Impact factor: 29.690

7.  STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation.

Authors:  P Gallagher; C Ryan; S Byrne; J Kennedy; D O'Mahony
Journal:  Int J Clin Pharmacol Ther       Date:  2008-02       Impact factor: 1.366

8.  The value of inpatient pharmaceutical counselling to elderly patients prior to discharge.

Authors:  S A Al-Rashed; D J Wright; N Roebuck; W Sunter; H Chrystyn
Journal:  Br J Clin Pharmacol       Date:  2002-12       Impact factor: 4.335

Review 9.  Polypharmacy in the aged. Practical solutions.

Authors:  R B Stewart; J W Cooper
Journal:  Drugs Aging       Date:  1994-06       Impact factor: 3.923

10.  Deciding when to stop: towards evidence-based deprescribing of drugs in older populations.

Authors:  Ian A Scott; Leonard C Gray; Jennifer H Martin; Peter I Pillans; Charles A Mitchell
Journal:  Evid Based Med       Date:  2012-11-07
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  4 in total

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Journal:  Drug Saf       Date:  2017-11       Impact factor: 5.606

Review 2.  Polypharmacy in Zoological Medicine.

Authors:  Robert P Hunter; Ramiro Isaza
Journal:  Pharmaceutics       Date:  2017-02-22       Impact factor: 6.321

Review 3.  Optimising prescribing practices in older adults with multimorbidity: a scoping review of guidelines.

Authors:  Penny Lun; Felicia Law; Esther Ho; Keng Teng Tan; Wendy Ang; Yasmin Munro; Yew Yoong Ding
Journal:  BMJ Open       Date:  2021-12-14       Impact factor: 2.692

4.  Attitudes and beliefs of patients and primary caregivers towards deprescribing in a tertiary health care facility.

Authors:  Narayan Gaurang; Rajendran Priyadharsini; Kandan Balamurugesan; Mathiyalagen Prakash; Devanathan Reka
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  4 in total

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