The process of deprescribing in older adults: a methodological protocol

Linkievicz, Natascha Melo; Engroff, Paula; Neto, Alfredo Cataldo; Sgnaolin, Vanessa

doi:10.53886/gga.e0220021

Cited by 2 publications

(8 citation statements)

References 28 publications

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“…In these situations, regular patient monitoring is essential. 12 Another barrier to deprescribing among older patients is patient resistance, which can be due to medication dependence or fear of interrupting or replacing treatment. 20 The drug classes most indicated for deprescribing in our sample were hypnotics/sedatives and anxiolytics, due to their classification as PIMs.…”

Section: Discussionmentioning

confidence: 99%

“…26 One strength of this study is that, before implementing the deprescribing process, the pharmacists developed a methodological protocol that described all necessary steps. 12 Meanwhile, the pharmacists emphasized the importance of deprescribing to the medical team through lectures and group discussion. During implementation, all physicians recognized the importance of deprescribing for the health of their older patients and managed to incorporate it into their routine outpatient care without problems.…”

Section: Discussionmentioning

confidence: 99%

“…All stages of the multidisciplinary team's deprescribing process, which consisted of physicians and pharmacists, have been previously published in detail as a methodological protocol. 12 The current study focused only on the deprescription of psychotropic drugs, disregarding other drug classes.…”

Section: Methodsmentioning

confidence: 99%

“…To this end, the physicians used deprescribing strategies and algorithms. 10,12,[19][20][21][22] Medications were either reduced gradually (gradual withdrawal) or stopped abruptly (abrupt withdrawal). While guiding the deprescribing process, the patient's real possibilities and individual preferences about pharmacological changes were observed.…”

Section: Methodsmentioning

confidence: 99%

“…7,11 Medication review may prevent possible drug-drug interactions and adverse drug reactions, reducing potential health risks. 12 In mental health care, deprescribing practices by an interdisciplinary team can expand care services and promote mental well-being among older adults. 9 Therefore, we aimed to describe the psychotropic drug deprescription process among older patients of a geriatric psychiatry outpatient clinic.…”

Section: Introductionmentioning

confidence: 99%

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Deprescribing psychotropic drugs in a geriatric psychiatry outpatient clinic

Linkievicz,

Sgnaolin,

Engrof

et al. 2024

Geriatr Gerontol Aging

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Objective: To describe the psychotropic drug deprescription process in older patients of a geriatric psychiatry outpatient clinic. Methods: We conducted a quasi-experimental study of people aged ≥ 60 years who were treated at Hospital São Lucas’ Geriatric Psychiatry Outpatient Clinic, which is affiliated with Pontifícia Universidade Católica do Rio Grande do Sul, Brazil. Data on 150 older people were collected from March 2021 to August 2022 and were evaluated by the pharmacists. The inclusion criteria were age ≥ 60 years, being a patient of the hospital’s Geriatric Psychiatry Outpatient Clinic, use of at least one psychotropic drug, and agreeing to participate in the study. Those unable to report their medications and those who only came to the first appointment were excluded. Results: Overall, deprescription of at least one psychotropic drug was indicated in 61.3% (n = 92) of the participants, and it was effectively implemented in 68.5% (n = 63) of this group. Deprescribing, which was more frequent in the youngest age group (60–69 years) (p = 0.049), was indicated for 37.4% (n = 136) of psychotropic drugs, 67.6% (n = 92) of which were effectively deprescribed. The main classes indicated for deprescription were hypnotics and sedatives (90.0%; n = 18) and anxiolytics (73.3%; n = 11). Conclusions: At least 1 psychotropic drug was indicated for deprescription in the majority of the patients, and in most cases it was effectively implemented. One-third of the prescribed psychotropic drugs were indicated for deprescription, and more than half were successfully deprescribed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Deprescribing psychotropic drugs in a geriatric psychiatry outpatient clinic

Linkievicz,

Sgnaolin,

Engrof

et al. 2024

Geriatr Gerontol Aging

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Is it possible to deprescribe benzodiazepine receptor agonists in older adults?

Güenter Dannebrock,

Engroff,

Sgnaolin

et al. 2023

PAJAR

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Aim: to analyze the viability and related factors for deprescribing benzodiazepine receptor agonists (BZRA).Methods: this is a longitudinal, prospective, interventional study performed with older adults assisted at a geriatric psychiatry outpatient clinic; these were divided into two groups: BZRA users and non-users. The instruments used in this study were a general questionnaire, the Geriatric Depression Scale (short form), the Geriatric Anxiety Inventory, and the Pittsburgh Sleep Quality Index.Results: we evaluated 74 patients, 40 (54.1%) of which were BZRA users and 34 (45.9%) were non-users, with an average age of 71.3 ± 7.5 years. Patients who used BZRA had a higher dropout rate of the deprescription process 26 (65%). Seven patients completely stopped using BZRAs (17.5%) and five reduced their use (12.5%). The mean scores for depression and anxiety symptoms were lower at the final assessment. As to sleep quality, BZRA users presented higher baseline values and both groups presented reductions in scores at the end of the treatment.Conclusion: deprescribing is viable and safe. However, there is resistance by both the patient and prescribers. The levels of anxiety, depression, and sleep quality improved after discontinuing BZRA.

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The process of deprescribing in older adults: a methodological protocol

Cited by 2 publications

References 28 publications

Deprescribing psychotropic drugs in a geriatric psychiatry outpatient clinic

Deprescribing psychotropic drugs in a geriatric psychiatry outpatient clinic

Is it possible to deprescribe benzodiazepine receptor agonists in older adults?

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