| Title: |
Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study |
| Authors: |
Pasina, Luca; Brignolo Ottolini, Barbara; Cortesi, Laura; Tettamanti, Mauro; Franchi, Carlotta; Marengoni, Alessandra; Mannucci, Pier Mannuccio; Nobili, Alessandro; REPOSI investigators; Zanetti, Michela |
| Contributors: |
Pasina, Luca; Brignolo Ottolini, Barbara; Cortesi, Laura; Tettamanti, Mauro; Franchi, Carlotta; Marengoni, Alessandra; Mannucci, Pier Mannuccio; Nobili, Alessandro; Reposi, Investigator; Zanetti, Michela |
| Publication Year: |
2019 |
| Collection: |
Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste) |
| Subject Terms: |
Elderly; End of life; Limited life expectancy; Polypharmacy; Symptomatic medications |
| Description: |
Objective: Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). Materials and Methods: We analyzed Registry of Polytherapies Societa Italiana di Medicina Interna (REPOSI), a network of internal medicine and geriatric wards, to describe the drug therapy of patients discharged with a limited life expectancy. Results: The study sample comprised 55 patients discharged with a limited life expectancy. Patients with at least 1 preventive medication that could be considered for deprescription at the end of life were significantly fewer from admission to discharge (n = 30; 54.5% vs. n = 21; 38.2%; p = 0.02). Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, lipid-lowering drugs, and clonidine were the most frequent potentially avoidable medications prescribed at discharge, followed by xanthine oxidase inhibitors and drugs to prevent fractures. Thirty-seven (67.3%) patients were also exposed to at least 1 potentially severe DDI at discharge. Conclusion: Hospital discharge is associated with a small reduction in the use of commonly prescribed preventive medications in patients discharged with a limited life expectancy. Cardiovascular drugs are the most frequent potentially avoidable preventive medications. A consensus framework or shared criteria for potentially inappropriate medication in elderly patients with limited life expectancy could be useful to further improve drug prescription. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/30889568; info:eu-repo/semantics/altIdentifier/wos/WOS:000507400600001; volume:28; issue:6; firstpage:501; lastpage:508; numberofpages:8; journal:MEDICAL PRINCIPLES AND PRACTICE; https://hdl.handle.net/11368/3052960; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944931/ |
| DOI: |
10.1159/000499692 |
| Availability: |
https://hdl.handle.net/11368/3052960; https://doi.org/10.1159/000499692; https://karger.com/mpp/article/28/6/501/207261/Need-for-Deprescribing-in-Hospital-Elderly; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944931/ |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.443A8B78 |
| Database: |
BASE |