SS2.03: Digital methods for medication review

Garfinkel, Doron; O’Mahoney, D.; Pasina, Luca; Jansen, P.A.F.

doi:10.1016/s1878-7649(14)70055-5

Cited by 1 publication

(3 citation statements)

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“…Even if the computer does not detect a simple interaction in a pair of drugs, prescribing more than 10 let alone 15 medications to older people is still likely to do more harm than good [Garfinkel and Mangin, 2010]. Garfinkel and Mangin suggested a much broader patientcentered approach that can accommodate to changing evidence, taking into consideration not only EBM but also clinical judgment and ethical issues, particularly patient and family preferences [Garfinkel and Mangin, 2010;Garfinkel, 2014].…”

Section: Computer-assisted Digital Tools Versus Patientcentered Methodsmentioning

confidence: 99%

“…So 'traditional' RCT tools are practically impossible; forget statistics, RCTs, EBM and computers as they are not there to support us. We have not yet arrived at a situation where any computer simulation can show us all the possible interactions among multiple medications, while factoring in the particular characteristics of a specific older patient [Garfinkel 2014].…”

Section: Conclusion and Suggestions: A Completely New Medicine Is Neementioning

confidence: 99%

“…Several computer programs can detect DDIs for a few different drugs. However, we have not yet arrived at a situation where any scientific method or computer simulation can show all possible interactions among multiple medications, while factoring in the particular characteristics of a specific patient; this is particularly true in patients of the VOCODFLEX subpopulations [Garfinkel, 2014].…”

Section: Drug-drug Interactionsmentioning

confidence: 99%

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Routine deprescribing of chronic medications to combat polypharmacy

Garfinkel

İlhan

Bahat

2015

Therapeutic Advances in Drug Safety

107

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The positive benefit-risk ratio of most drugs is decreasing in correlation to very old age, the extent of comorbidity, dementia, frailty and limited life expectancy (VOCODFLEX). First, we review the extent of inappropriate medication use and polypharmacy (IMUP) globally and highlight its negative medical, nursing, social and economic consequences. Second, we expose the main clinical/practical and perceptual obstacles that combine to create the negative vicious circle that eventually makes us feel frustrated and hopeless in treating VOCODFLEX in general, and in our 'war against IMUP' in particular. Third, we summarize the main international approaches/methods suggested and tried in different countries in an attempt to improve the ominous clinical and economic outcomes of IMUP; these include a variety of clinical, pharmacological, computer-assisted and educational programs. Lastly, we suggest a new comprehensive perception for providing good medical practice to VOCODFLEX in the 21st century. This includes new principles for research, education and clinical practice guidelines completely different from the 'single disease model' research and clinical rules we were raised upon and somehow 'fanatically' adopted in the 20th century. This new perception, based on palliative, geriatric and ethical principle, may provide fresh tools for treating VOCODFLEX in general and reducing IMUP in particular.

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Section: Computer-assisted Digital Tools Versus Patientcentered Methodsmentioning

confidence: 99%

Section: Conclusion and Suggestions: A Completely New Medicine Is Neementioning

confidence: 99%

Section: Drug-drug Interactionsmentioning

confidence: 99%

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