scholarly journals Examining Success Factors in Deprescribing Proposals from Community Pharmacists

2021 ◽  
Author(s):  
Shin Osada
Keyword(s):  
Adverse Events ◽  
Observational Study ◽  
Success Rate ◽  
Success Factors ◽  
Community Pharmacists ◽  
Critical Issue ◽  
Potentially Inappropriate Medications ◽  
Face To Face ◽  
Unused Medications ◽  
Inappropriate Medications

Abstract Background: Polypharmacy is a critical issue that affects elderly people in particular. In Japan, fees to support deprescription are calculated bycommunity pharmacists who propose deprescribing 2 or more medications for patients prescribed 6 or more. However, the fees are rarely calculated.The objective of this study is toexamine success factors in deprescribing proposals submitted bycommunity pharmacists to prescribing doctors.Methods: Tracing reports submitted from Aug 2017 to Mar 2020 were investigated retrospectively to uncover factors that influenced the success of deprescribing using statisticalanalyses.Results:One hundred and twenty-three unique tracing reports were submitted to the prescribing doctors. Of these, 67 reports were successful in deprescribing and 56 failed; the success rate was 54.5%. Deprescribing proposals with existingunused medications significantly increased the deprescribing success rate. Possible adverse events, potentially inappropriate medications, and overlapping medications with the same effecttended to increase the success rate, but not significantly. Whether the pharmacist experienced face-to-face communication with the prescribing doctors did not significantly influence the outcome.Conclusions:Tracing reports with deprescribing proposals submitted by community pharmacists may help resolve problems arising frompolypharmacy. Mentioning unused medications could increase the deprescribing success rate.Trial registration: This study did not registered due to purely observational study.

scholarly journals Searching for Success Factors in Deprescribing Proposals from Community Pharmacists

2021 ◽  
Author(s):  
Shin Osada
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Elderly People ◽  
Success Factors ◽  
Community Pharmacists ◽  
Doctor Who ◽  
Study Success ◽  
Face To Face ◽  
Unused Medications ◽  
Critical Issues

Abstract BackgroundPolypharmacy is one of the most critical issues worldwide, especially in elderly people. In Japan, fees to support deprescription were established in 2018 which are calculated as the community pharmacists propose deprescribing in patients prescribed 6 or more medications regularly by submitting documents to the prescribing doctor, who may withdraw 2 or more medications. However, these are hardly calculated though many deprescribing proposals submitted.ObjectiveThe objective in this study, success factors in deprescribing proposals from the community pharmacists to prescribing doctors were searched for.MethodsTracing reports submitted from Aug 2017 to Mar 2020 were investigated retrospectively and factors that influenced the success of deprescribing were searched for.ResultsOne hundred and twenty-three tracing reports (67 reports of successful deprescribing and 56 reports of failure, success rate was 54.5%) were submitted to the prescribing doctors. Deprescribing proposals with existing unused medications or an assessment of possible adverse events significantly increased the deprescribing success rate. Whether the pharmacist experienced face-to-face communication with the prescribing doctors was not significant.ConclusionTracing reports with deprescribing proposals submitted by the community pharmacists may resolve polypharmacy. Mentioning unused medications or possible adverse events could increase the deprescribing success rate.

Potentially Inappropriate Medications Use in A Population of Iraqi Geriatric Outpatients According to Beers Criteria

2019 ◽  
Vol 10 (02) ◽  
Author(s):  
Ola Albaghdadi ◽  
Salam , Mohammad Hassan Morteza, Firas A Ahjel ◽  
Mohammad Hassan Morteza ◽  
Firas Aziz Rahi
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Public Health Issue ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Face To Face ◽  
Inappropriate Drugs ◽  
Elderly Outpatients ◽  
Inappropriate Medications

Aims: Elderly in Iraq kept suffering multiple burdens, as they are a truly fragile and vulnerable segment. A major public health issue among elderly is adverse drug reactions. This study is aimed at contributing in overcoming this treatment gap by determining the prevalence of inappropriate medications used by a group of Iraqi elderly outpatients. Methods: A cross-sectional, questionnaire-based study was conducted in a sample of 85 Iraqi elderly aged ≥65 years of either gender. Participants had face-to-face interviews to answer a comprehensive questionnaire. Each drug taken by the patient was evaluated according to Beers criteria. Results: Females constituted 45.9% of the total. The average age was 69.9 years (± 4.6). Nearly 30% of the patients had 3 different diseases, and 17.8% had ≥4 different ones, with cardiovascular diseases were the most prevalent. Polypharmacy was notably identified in 47.1% of the total studied population. Twenty-eight out of 85 patients did not know the actual reason of taking at least one of their medications, and 42% were not taking their drugs as directed. Remarkably, 43.5% of patients were recognized as taking at least one medication to be avoided in elderly people according to the Beers criteria. The most common inappropriate drugs were glyburide, and proton-pump inhibitors. Conclusion: There was an obvious absence of any role of pharmacists in the health care system for our studied population. Health care professionals are encouraged to review the medications prescribed for geriatric patients using updated safety guidelines to prevent the risks associated with potentially inappropriate medications.

scholarly journals Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

2017 ◽  
Vol 150 (3) ◽  
pp. 169-183 ◽  
Author(s):  
Tejal Patel ◽  
Karen Slonim ◽  
Linda Lee
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

Background: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use. Methods: MEDLINE, EMBASE, CINAHL, and International Pharmaceutical Abstracts were searched between 1946 and 2014 for articles that referenced potentially inappropriate medication use and types of dementia. One reviewer screened all titles and abstracts from the initial search and full-text articles after the initial screen for eligibility, then 2 reviewers independently abstracted data from included studies. Results: Searches yielded 81 articles, of which 7 met inclusion criteria. Prevalence of potentially inappropriate medication use varied from 15% to 46.8%. No single drug or drug class was reported consistently across all studies as the most frequent potentially inappropriate medication, but anticholinergics and benzodiazepines, drugs that affect cognition, were among the most common medications or pharmacological classes listed. Discussion: Older adults with dementia may be particularly vulnerable to potentially inappropriate medications because of cognitive impairment from their condition and the greater likelihood of experiencing adverse events from medications. Given this population’s greater susceptibility to adverse events, more intense medication and patient monitoring may be warranted, especially among those taking anticholinergics and benzodiazepines, as these drugs can contribute to cognitive impairment.

Polypharmacy, potentially inappropriate medications, and chemotherapy-related adverse events among older adults with cancer.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. e19501-e19501 ◽  
Author(s):  
R. J. Maggiore ◽  
C. P. Gross ◽  
M. Hardt ◽  
W. P. Tew ◽  
S. G. Mohile ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Events ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medications

scholarly journals Why deprescribing instead of not prescribing?

2020 ◽  
Vol 14 (4) ◽  
pp. 294-297
Author(s):  
Welma Wildes Amorim ◽  
Luiz Carlos Passos ◽  
Marcio Galvão Oliveira
Keyword(s):  
Adverse Events ◽  
Older People ◽  
Cognitive Processes ◽  
Older Patients ◽  
Potentially Inappropriate Medications ◽  
Patient Harm ◽  
Serious Adverse Events ◽  
Inappropriate Medications ◽  
Appropriate Prescription

Prescribing medications involves complex cognitive processes, and mistakes in prescription can cause serious adverse events. Deprescribing is one of the last opportunities to prevent patient harm from the use of drugs that should be avoided, especially among older patients. This viewpoint article aims to discuss the prescription process and some essential concepts, such as polypharmacy, prescription of potentially inappropriate medications, and, particularly, the relevance of deprescribing and its relationship with the appropriate prescription of medications in older people.

scholarly journals PRESCRIPTION ANALYSIS AND PREVALENCE OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULTS; AN OBSERVATIONAL STUDY

2020 ◽  
pp. 108-112
Author(s):  
N. SENTHIL KUMAR ◽  
GEENA K. REJI ◽  
REEMA K. A. ◽  
VIJAYARANGAN S. ◽  
RAMYA A.
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Adverse Drug Reactions ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Potentially Inappropriate Medications ◽  
Drug Reactions ◽  
Geriatric Population ◽  
Institutional Ethics ◽  
Inappropriate Medications

Objective: The objectives of the present study were to determine the prevalence of Potentially Inappropriate Medications and Adverse Drug Reactions in older adults and to collect doctors’ responses regarding the PIM list or any other criteria to treat older adults in India. Methods: This was an observational study conducted in different tertiary care hospitals of two districts, Erode and Salem after obtaining approval of the Institutional Ethics Committee. A sample of 250 older adults (60 y and above) and 97 doctors were included during the study period of 6 mo from February 2019 to July 2019. Inappropriate medications were identified by using 2019 updated Beer’s criteria. The causality of the adverse events was assessed by Naranjo Adverse Drug Reaction Probability Scale. Results: Out of the 250 prescriptions, only 86(34.4%) of the prescriptions were appropriate and 164(65.6%) were inappropriate. The most commonly inappropriate prescribed medications were diuretics, ranitidine, and tramadol. A total of 74 ADRs was observed in 74 patients. Of these, 57(22.8%) ADRs were due to inappropriate medications listed in Beers criteria. There was a significant association between the occurrence of ADRs and the use of PIMs listed in 2019 updated Beer’s criteria [χ2 = 6.08, P = 0.013 (df = 1)]. Conclusion: The study shows that there is a high prevalence of inappropriate medications and adverse drug reactions in hospitalized older adults. Beer’s criteria can be used as a guideline by the physicians while prescribing the drugs to the geriatric population.

scholarly journals Polypharmacy and Potentially Inappropriate Medications in Patients With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 208-208
Author(s):  
Ryo Nonaka ◽  
Atsuhiro Kanno ◽  
Takahiro Ohara ◽  
Kazuhiro Sumitomo ◽  
Shigeru Sato ◽  
...  
Keyword(s):  
Inappropriate Medication ◽  
Lewy Bodies ◽  
Critical Issue ◽  
University Hospital ◽  
Potentially Inappropriate Medications ◽  
Medical Institutions ◽  
Number Of Patients ◽  
Prescribed Medicines ◽  
Definition Of ◽  
Inappropriate Medications

Abstract INTRODUCTION: The use of polypharmacy and potentially inappropriate medication (PIM) is a critical issue in geriatrics. Furthermore, the number of patients with dementia is dramatically increasing worldwide. In this study, we investigated: (1) if the states of polypharmacy and PIM differed in patients with and without dementia; (2) the types of medicine that were commonly prescribed; (3) the types of dementia that resulted in the prescription of multiple medicines; (4) if there was a correlation between the number of medicines and the number of medical institutions (hospitals and clinics) that the patients attended. METHODS: In total, 216 patients who were 65 years of age and older were analyzed. The number of medicines prescribed and the medical institutions they attended were counted through the electronic medical charts of Tohoku Medical and Pharmaceutical University Hospital. We employed the Beers 2019 criteria for the definition of PIM. RESULTS: (1) The number of prescribed medicines was not significantly different between patients with dementia and those without dementia. (2) Anti-hypertensives and gastro-intestinal medicines were the most commonly prescribed medicines in patients with and without dementia. (3) Patients with “dementia with Lewy bodies” and “mixed dementia” were prescribed the highest number of medicines. (4) The number of medicines and PIM use were significantly and positively correlated with the number of medical institutions. CONCLUSIONS: The number of medical institutions strongly affected the number of medicines prescribed and PIM use. Efforts should be made to organize and reduce the number of medical institutions that a patient attends.

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