Balancing medication use in nursing home residents with life-limiting disease

Abstract

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Potential prescribing omissions may have no influence on cause of death in care‐dependent older adults with percutaneous endoscopic gastrostomy tube

“…In Japan, guidelines for medication review for older adults were published in 2015, and there has been increasing use of the guidelines among clinicians and pharmacists 22 ; thus, rational deprescribing has been conducted. A similar finding was reported in another country, 23 which implied increased awareness among geriatricians of appropriate pharmacotherapy for older adults. In addition, there is a bundled payment system in geriatric facilities such as long‐term care hospitals and Geriatric Health Services facilities (ROKEN) in Japan.…”

Attitudes and beliefs of older adults and caregivers towards deprescribing in French-speaking countries: a multicenter cross-sectional study

“…Previous international studies have reported older adults' and caregivers' openness to deprescribing, but few have concurrently assessed older adults' and caregivers' attitudes. To our knowledge, only one included French-speaking participants and none have included populations from multiple countries, to increase the external validity of study results regarding perceptions of deprescribing [26,28,[29][30][31][32][33]. The recent validation of the rPATD questionnaire in French [34] allows the assessment of attitudes towards deprescribing in both older adults and caregivers among French speaking countries, and thus may permit to position these French-speaking countries on their openness to deprescribing compared to other countries.…”

Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life

“…When prescription information is available in patients’ complete health records, a pharmacotherapy review can provide an accurate “point prevalence” (i.e., prevalence at a particular point of time) of patients’ medication use by day [ 23 ] or during the data collection period [ 24 , 25· , 26·· , 27·· ]. When such patient-level data is not available, linked registry databases [ 28·· , 29· ] or administrative datasets such as the Minimum Data Set [ 30 ] have been used to determine the “period prevalence” (i.e., prevalence over an interval of time) of polypharmacy.…”