Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study
| Title: | Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study |
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| Authors: | Pasina L; Brignolo Ottorini B; Cortesi L; Tettamanti M; Franchi C; Marengoni A; Mannucci PM; Nobili A; Prisco D; Silvestri E; Cenci C; Emmi G; Biolo G; Zanetti M; Guadagni M; Zaccari M; Vanoli M; Grignani G; Pulixi EA; Bernardi M; Li Bassi S; Santi L; Zaccherini G; Mannarino E; Lupattelli G; Bianconi V; Paciullo F; Nuti R; Valenti R; Ruvio M; Cappelli S; Palazzuoli A; Olivieri O; Girelli D; Matteazzi T; Barbagallo M; Dominguez L; Cocita F; Beneduce V; Plances L; Zoli M; Lazzari I; Brunori M; Laghi Pasini F; Capecchi PL; Palasciano G; Modeo ME; Di Gennaro C; Cappellini MD; Maira D; Di Stefano V; Fabio G; Seghezzi S; Mancarella M; Cesari M; Dionigi Rossi P; Damanti S; Clerici M; Conti F; Corazza GR; Miceli E; Lenti MV; Pisati M; Caccia Dominioni C; Murialdo G; Marra A; Cattaneo F; Secchi MB; Ghelfi D; Anastasio L; Sofia L; Carbone M; Cipollone F; Guagnano MT; Angelucci E; Valeriani E; Mancuso G; Calipari D; Bartone M; Delitala G; Berria M; Muscaritoli M; Molfino A; Petrillo P; Zuccalà G; D’Aurizio G; Romanelli G; Zucchelli A; Dell’Unto C; Annoni G; Corsi M; Bellelli G; Zazzetta S; Mazzola P; Szabo H; Bonfanti A; Arturi F; Succurro E; Rubino M; Serra MG; Bleve MA; Gasbarrone L; Sajeva MR; Brucato A; Ghidoni S; Fabris F; Bertozzi I; Bogoni G; Rabuini MV; Cosi E; Manfredini R; Fabbian F; Boari B; De Giorgi A; Tiseo R; Paolisso G; Rizzo MR; Borghi C; Strocchi E; De Sando V; Pareo I; Sabbà C; Vella FS; Suppressa P; Agosti P; Schilardi A; Loparco F; Fenoglio L; Bracco C; Giraudo AV; Fargion S; Periti G; Porzio M; Tiraboschi S; Peyvandi F; Rossio R; Ferrari B; Colombo G; Monzani V; Savojardo V; Folli C; Ceriani G; Salerno F; Pallini G; Dallegri F; Ottonello L; Liberale L; Caserza L; Salam K; Liberato NL; Tognin T; Bianchi GB; Giaquinto S; Purrello F; Di Pino A; Piro S; Rozzini R; Falanga L; Spazzini E; Ferrandina C; Montrucchio G; Petitti P; Salmi R; Gaudenzi P; Violi F; Perri L; Landolfi R; Montalto M; Mirijello A; Guasti L; Castiglioni L; Maresca A; Squizzato A; Molaro M; Grossi A; Bertolotti M; Mussi C; Libbra MV; Dondi G; Pellegrini E; Carulli L; Perticone F; Colangelo L; Falbo T; Stanghellini V; De Giorgio R; Ruggeri E; del Vecchio S; Salvi A; Leonardi R; Damiani G; Gabrielli A; Capeci W; Mattioli M; Martino GP; Biondi L; Pettinari P; Ghio R; Dal Col A; Minisola A; Afeltra A; Marigliano B; Pipita ME; Castellino P; Blanco J; Zanoli L; Pignataro S; Saracco V; Fogliati M; Bussolino C; Mete F; Gino M; Cittadini A; Vigorito C; Arcopinto M; Salzano A; Bobbio E; Marra AM; Sirico D; Moreo G; Gasparini F; Prolo S; Pina G; Ballestrero A; Ferrando F; Berra S; Dessi S; Nava MC; Graziella B; Baldassarre S; Fragapani S; Gruden G; Galanti G; Mascherini G; Petri C; Stefani C; Girino M; Piccinelli V; Nasso F; Gioffrè V; Pasquale M; Scattolin G; Martinelli S; Turrin M; Sechi L; Catena C; Colussi G; Passariello N; Rinaldi L; Berti F; Famularo G; Tarsitani P; Castello R; Pasino M; Ceda GP; Maggio MG; Morganti S; Artoni A; Del Giacco S; Firinu D; Losa F; Paoletti G; Montalto G; Licata A; Malerba V; Lasco A; Basile G; Catalano A; Malatino L; Stancanelli B; Terranova V; Di Marca S; Mecocci P; Ruggiero C; Boccardi V; Meschi T; Lauretani F; Ticinesi A; Minuz P; Fondrieschi L; Pirisi M; Fra GP; Sola D; Porta M; Riva P; Quadri R; Scanzi S; Mengoli C; Provini S; Ricevuti L; Simeone E; Scurti R; Tolloso F; Tarquini R; Valoriani A; SDolenti S; Vannin G; Tedeschi A; Trotta L; Volpi R; Bocchi P; Vignali A; Harari S; Lonati C; Cattaneo M; Ramirez Duque N; Muela Molinero A; Abad Requejo P; Lopez Pelaez V; Tamargo L; Corbella Viros X; Formiga F; Diez Manglano J; Bejarano Tello E; Del Corral Behamonte E; Sevil Puras M; Romero M; Pinilla LB; Lopez Gonzalez-Cobos C; Villalba Garcia MV; Saez L; Bosco J; Sanz Baena S; Arroyo Gallego Marta; Gonzalez Becerra C; Fernandez Moyano A; Gomez Hernandez M; Poyato Borrego M; Pacheco Cuadros R; Perez Rojas F; Garcia Olid B; Carrascosa Garcia S; Gonzalez-Cruz Cervellera A; Peinado Martinez M; Ruiz Cantero A; Albarracín Arraigosa A; Godoy Guerrero M; Barón Ramos MA; Machin JM; Novo Veleiro I; Alvela Suarez; Lopez A; Rubal Bran D; Iñiguez Vazquez I; Rios Prego M. |
| Contributors: | Pasina, L; Brignolo Ottorini, B; Cortesi, L; Tettamanti, M; Franchi, C; Marengoni, A; Mannucci, Pm; Nobili, A; Prisco, D; Silvestri, E; Cenci, C; Emmi, G; Biolo, G; Zanetti, M; Guadagni, M; Zaccari, M; Vanoli, M; Grignani, G; Pulixi, Ea; Bernardi, M; Li Bassi, S; Santi, L; Zaccherini, G; Mannarino, E; Lupattelli, G; Bianconi, V; Paciullo, F; Nuti, R; Valenti, R; Ruvio, M; Cappelli, S; Palazzuoli, A; Olivieri, O; Girelli, D; Matteazzi, T; Barbagallo, M; Dominguez, L; Cocita, F; Beneduce, V; Plances, L; Zoli, M; Lazzari, I; Brunori, M; Laghi Pasini, F; Capecchi, Pl; Palasciano, G; Modeo, Me; Di Gennaro, C; Cappellini, Md; Maira, D; Di Stefano, V; Fabio, G; Seghezzi, S; Mancarella, M; Cesari, M; Dionigi Rossi, P; Damanti, S; Clerici, M; Conti, F; Corazza, Gr; Miceli, E; Lenti, Mv; Pisati, M; Caccia Dominioni, C; Murialdo, G; Marra, A; Cattaneo, F; Secchi, Mb; Ghelfi, D; Anastasio, L; Sofia, L; Carbone, M; Cipollone, F; Guagnano, Mt; Angelucci, E; Valeriani, E; Mancuso, G; Calipari, D; Bartone, M; Delitala, G; Berria, M; Muscaritoli, M; Molfino, A; Petrillo, P; Zuccalà, G; D’Aurizio, G; Romanelli, G; Zucchelli, A; Dell’Unto, C; Annoni, G; Corsi, M; Bellelli, G; Zazzetta, S; Mazzola, P; Szabo, H; Bonfanti, A; Arturi, F; Succurro, E; Rubino, M |
| Publication Year: | 2019 |
| Collection: | Università degli Studi di Ferrara: CINECA IRIS |
| 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 |
| File Description: | STAMPA |
| 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/11392/2411109; https://www.karger.com/Article/Fulltext/499692 |
| DOI: | 10.1159/000499692 |
| Availability: | https://hdl.handle.net/11392/2411109; https://doi.org/10.1159/000499692; https://www.karger.com/Article/Fulltext/499692 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: | edsbas.DB5ECB7F |
| Database: | BASE |