Deprescribing in Older Adults With Cardiovascular Disease.

Aged Cardiovascular Diseases / drug therapy Comorbidity Deprescriptions Drug-Related Side Effects and Adverse Reactions / epidemiology Global Health Humans Inappropriate Prescribing / prevention & control Incidence
deprescribing geriatrics medications multimorbidity multiple chronic conditions older adults polypharmacy

Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
28 05 2019
Historique:
received: 22 02 2019
accepted: 12 03 2019
entrez: 24 5 2019
pubmed: 24 5 2019
medline: 1 4 2020
Statut: ppublish

Résumé

Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing is particularly applicable to the commonly encountered multimorbid older adult with cardiovascular disease and concomitant geriatric conditions such as polypharmacy, frailty, and cognitive dysfunction-a combination rarely addressed in current clinical practice guidelines. Triggers to deprescribe include present or expected adverse drug reactions, unnecessary polypharmacy, and the need to align medications with goals of care when life expectancy is reduced. Using a framework to deprescribe, this review addresses the rationale, evidence, and strategies for deprescribing cardiovascular and some noncardiovascular medications.

Identifiants

DOI: 10.1016/j.jacc.2019.03.467 PMID: 31118153 PMC: PMC6724706
pubmed: 31118153
pii: S0735-1097(19)34571-1
doi: 10.1016/j.jacc.2019.03.467
pmc: PMC6724706
mid: NIHMS1039137
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2584-2595

Subventions

Organisme : NIA NIH HHS
ID : R03 AG064373
Pays : United States
Organisme : NIA NIH HHS
ID : L30 AG060493
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG056446
Pays : United States
Organisme : NIA NIH HHS
ID : L30 AG060521
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG036778
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG049057
Pays : United States
Organisme : NIA NIH HHS
ID : U13 AG047008
Pays : United States

Informations de copyright

Copyright © 2019. Published by Elsevier Inc.

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Auteurs

Ashok Krishnaswami (A)

Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California. Electronic address: ashok.krishnaswami@kp.org.

Michael A Steinman (MA)

Division of Geriatrics, University of California, San Francisco, California; Division of Geriatrics, San Francisco Veterans Affairs Medical Center, San Francisco, California.

Parag Goyal (P)

Division of Cardiology and Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York.

Andrew R Zullo (AR)

Departments of Health Services, Policy, Practice and Epidemiology, Brown University School of Public Health, Providence, Rhode Island; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island.

Timothy S Anderson (TS)

Division of General Internal Medicine, University of California, San Francisco, California.

Kim K Birtcher (KK)

University of Houston College of Pharmacy, Houston, Texas.

Sarah J Goodlin (SJ)

Geriatrics Section, Veterans Affairs Portland Health Care System, Portland, Oregon; Department of Medicine, Oregon Health and Sciences University, Portland, Oregon.

Mathew S Maurer (MS)

Division of Cardiology, Columbia University Medical Center, New York, New York.

Karen P Alexander (KP)

Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.

Michael W Rich (MW)

Cardiovascular Division, Washington University, St. Louis, Missouri.

Jennifer Tjia (J)

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Deprescribing in Older Adults With...
questionsmedicales.fr › Maladies cardiovasculaires › Deprescribing in Older Adults With...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Comorbidité › Deprescribing in Older Adults With...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Déprescriptions › Deprescribing in Older Adults With...
questionsmedicales.fr › Troubles dus à des produits chimiques › Effets secondaires indésirables des médicaments › Deprescribing in Older Adults With...
questionsmedicales.fr › Caractéristiques de la population › Santé › Santé mondiale › Deprescribing in Older Adults With...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Deprescribing in Older Adults With...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Erreurs médicales › Erreurs de médication › Prescription inappropriée › Deprescribing in Older Adults With...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Deprescribing in Older Adults With...