Retrospective analysis of a pilot pharmacist-led hospice deprescribing program initiative.
Aged
Aged, 80 and over
Cardiovascular Diseases
/ drug therapy
Delivery of Health Care, Integrated
/ methods
Deprescriptions
Feasibility Studies
Female
Hospice Care
/ methods
Humans
Male
Neoplasms
/ drug therapy
Palliative Care
/ methods
Pharmaceutical Services
Pharmacists
Pilot Projects
Quality of Life
Retrospective Studies
Treatment Outcome
comfort care
deprescribing
hospice
pharmacist
polypharmacy
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
18
02
2021
received:
18
11
2020
accepted:
23
02
2021
pubmed:
28
3
2021
medline:
29
9
2021
entrez:
27
3
2021
Statut:
ppublish
Résumé
Medication deprescribing in palliative care settings has been insufficiently studied. To determine the feasibility of a deprescribing program in hospice patients with limited life expectancy. Pharmacist-led, single arm, single-centered, retrospective analysis of a pilot deprescribing program in an integrated healthcare delivery organization between 9/1/2018 to 1/31/2019. The primary outcome was the proportion of patients who achieved ≥50% reduction of the recommended medications to deprescribe. A total of 97 patients were included in the analysis. The average age was 77.5 ± 23.7 years, with 53.6% being women and 54.6% white. The most common primary diagnosis was cancer (58.8%), with cardiovascular disease the next most common (15.5%). The mean number of baseline comorbidities was 2.0 ± 1.6. Of 698 prescriptions at the start of hospice enrollment, 79.4% of patients achieved a ≥50% reduction in medications recommended for deprescribing. This success was seen mostly in cardiovascular and other nonspecific medications. We found that every 1-unit increase in the number of patient encounters with hospice pharmacists was associated with a 3.2-fold higher odds of achieving a ≥50% reduction in medications that were recommended for deprescribing. The findings from this pilot study revealed that a collaborative, pharmacist-led, collaborative medication deprescribing program initiative was associated with a 79% success in ≥50% medication reduction. More frequent patient encounters had higher odds of success. Future studies, utilizing a control group, should focus on determining the effectiveness of the program and the impact on quality of life.
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1370-1376Informations de copyright
© 2021 The American Geriatrics Society.
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