Patient safety: A progressive deprescribing model in patients with advanced solid tumors assisted at Instituto Oncológico Henry Moore (IOHM)

Autor:	Mariana Abal, Marcelo Muino, Monica Montiel, Carlos Fernando Garcia Gerardi, Edgardo G. J. Rivarola, Eduardo L. Morgenfeld, Ernesto Gil Deza, Sandra L. Ares, Flavio Tognelli, Felipe G. Gercovich
Rok vydání:	2017
Předmět:	Polypharmacy Cancer Research medicine.medical_specialty business.industry 03 medical and health sciences Patient safety 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Health care Medicine In patient 030212 general & internal medicine Deprescribing business Intensive care medicine
Zdroj:	Journal of Clinical Oncology. 35:6594-6594
ISSN:	1527-7755 0732-183X
DOI:	10.1200/jco.2017.35.15_suppl.6594
Popis:	6594 Background: "Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes" ( Br J Clin Pharmacol 80:6, 1254. 2015). The aim of this paper is to present a model for deprescribing used at IOHM. Methods: Between 09/26/2012 and 09/26/2016, 10,053 pt filled out a Past Medical History Form, listing all the medications they were taking regularly. We selected all the pt. with advanced solid tumors (AST). In each pt the expected survival was established in order to evaluate the usefulness of the Tx. The drugs were classified in three groups: A) Green: Adequate (must be maintained); B) Yellow: Questionable (could be maintained or removed) or C) Red: Avoidable (must be removed). Results: We registered 2,103 pt who met the inclusion criteria. Sex F/M: 905 /1198. Median age 63 y (r = 19-99). A total of 1,629 pt. (77%) were taking medications on a regular basis. The total amount of medications was 5,679 . Median medications per patient: 3 (range: 1-14). Eighty percent of the pt (1,298 pt) were receiving questionable of avoidable medications. The following table shows the distribution of medications per group. Conclusions: A) In this cohort of 2,103 pt with AST, half of them had an average life expectancy of less than one year. B) 1,298 out of 1,629 pt (80%) were receiving a questionable medication C) 596/5,769 (10%) of the registered drugs, had to be suspended immediately and at least a thousand more could be eliminated. d) Obstacles to deprescribing were essentially medical ignorance, fear and inexperience. [Table: see text]
Databáze:	OpenAIRE
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