Joseph T Hanlon1, Jennifer Tjia2. 1. 1University of Pittsburgh, Department of Medicine, Pittsburgh, Pennsylvania. 2. 3University of Massachusetts Medical School, Department of Population and Quantitative Health Sciences, Worcester, Massachusetts.
Abstract
OBJECTIVE: To provide clinicians with information about avoiding adverse drug withdrawal events (ADWEs) when discontinuing unnecessary medications as per the STOPPFrail criteria. DATA SOURCES: Searches of MEDLINE (1970-June 2020), the Cochrane Database of Systematic Reviews (through June 2020), Google Scholar (through June 2020). STUDY SELECTION: Reviews and original studies of ADWEs. DATA EXTRACTION: Tapering protocols for specific drugs/ classes from randomized controlled deprescribing trials. DATA SYNTHESIS: Six drug classes were identified as being high risk for physiological ADWEs. CONCLUSION: The occurrence of ADWEs is rare in comparison to adverse drug reactions in older adults. Few drugs/classes have been reported to have physiological ADWEs with abrupt discontinuation. For these we provide information about tapering protocols and symptom monitoring to avoid ADWEs.
OBJECTIVE: To provide clinicians with information about avoiding adverse drug withdrawal events (ADWEs) when discontinuing unnecessary medications as per the STOPPFrail criteria. DATA SOURCES: Searches of MEDLINE (1970-June 2020), the Cochrane Database of Systematic Reviews (through June 2020), Google Scholar (through June 2020). STUDY SELECTION: Reviews and original studies of ADWEs. DATA EXTRACTION: Tapering protocols for specific drugs/ classes from randomized controlled deprescribing trials. DATA SYNTHESIS: Six drug classes were identified as being high risk for physiological ADWEs. CONCLUSION: The occurrence of ADWEs is rare in comparison to adverse drug reactions in older adults. Few drugs/classes have been reported to have physiological ADWEs with abrupt discontinuation. For these we provide information about tapering protocols and symptom monitoring to avoid ADWEs.
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