How many older adults receive drugs of questionable clinical benefit near the end of life? A cohort study.

Aged Aged, 80 and over Female Frail Elderly Humans Inappropriate Prescribing Male Medical Futility Neoplasms Palliative Care Registries Retrospective Studies Sweden Terminal Care
Drug utilization cohort studies deprescriptions drug therapy frail elderly geriatrics inappropriate prescribing palliative care

Journal

Palliative medicine
ISSN: 1477-030X
Titre abrégé: Palliat Med
Pays: England
ID NLM: 8704926

Informations de publication

Date de publication:
09 2019
Historique:
pubmed: 8 6 2019
medline: 30 5 2020
entrez: 8 6 2019
Statut: ppublish

Résumé

The high burden of disease-oriented drugs among older adults with limited life expectancy raises important questions about the potential futility of care. To describe the use of drugs of questionable clinical benefit during the last 3 months of life of older adults who died from life-limiting conditions. Longitudinal, retrospective cohort study of decedents. Death certificate data were linked to administrative and healthcare registries with national coverage in Sweden. Older adults (≥75 years) who died from conditions potentially amenable to palliative care between 1 January and 31 December 2015 in Sweden. We identified drugs of questionable clinical benefit from a set of consensus-based criteria. A total of 58,415 decedents were included (mean age, 87.0 years). During their last 3 months of life, they received on average 8.9 different drugs. Overall, 32.0% of older adults A substantial share of older persons with life-limiting diseases receive drugs of questionable clinical benefit during their last months of life. Adequate training, guidance and resources are needed to rationalize and deprescribe drug treatments for older adults near the end of life.

Sections du résumé

BACKGROUND
The high burden of disease-oriented drugs among older adults with limited life expectancy raises important questions about the potential futility of care.
AIM
To describe the use of drugs of questionable clinical benefit during the last 3 months of life of older adults who died from life-limiting conditions.
DESIGN
Longitudinal, retrospective cohort study of decedents. Death certificate data were linked to administrative and healthcare registries with national coverage in Sweden.
SETTING
Older adults (≥75 years) who died from conditions potentially amenable to palliative care between 1 January and 31 December 2015 in Sweden. We identified drugs of questionable clinical benefit from a set of consensus-based criteria.
RESULTS
A total of 58,415 decedents were included (mean age, 87.0 years). During their last 3 months of life, they received on average 8.9 different drugs. Overall, 32.0% of older adults
CONCLUSION
A substantial share of older persons with life-limiting diseases receive drugs of questionable clinical benefit during their last months of life. Adequate training, guidance and resources are needed to rationalize and deprescribe drug treatments for older adults near the end of life.

Identifiants

DOI: 10.1177/0269216319854013 PMID: 31172885 PMC: PMC6691599
pubmed: 31172885
doi: 10.1177/0269216319854013
pmc: PMC6691599
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1080-1090

Commentaires et corrections

Type : CommentIn

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Auteurs

Lucas Morin (L)

1 Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
2 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
ORCID: 0000-0002-8486-8610

Jonas W Wastesson (JW)

1 Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
2 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Marie-Laure Laroche (ML)

3 Centre de pharmacovigilance et de pharmaco-épidémiologie, Department of Pharmacology-Toxicology and Centre of Pharmacovigilance, CHU Limoges, Limoges, France.
4 INSERM 1248, University of Limoges, CHU Limoges, Limoges, France.

Johan Fastbom (J)

1 Aging Research Center, Karolinska Institutet, Stockholm, Sweden.

Kristina Johnell (K)

2 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

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questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › How many older adults receive drugs of...
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