Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life
| Autor: | Attah K Mbrah, Cara L. McDermott, Jennifer L. Lund, Seun Osundolire, Jennifer Tjia, Deborah S Mack, Yiyang Yuan, Qiaoxi Chen |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Operationalization business.industry Outcome measurement Context (language use) Caregiver burden Article 03 medical and health sciences 0302 clinical medicine Harm Quality of life (healthcare) Deprescribing Medication appropriateness 030220 oncology & carcinogenesis End of life Methods medicine Life expectancy General Earth and Planetary Sciences In patient Methodological 030212 general & internal medicine Intensive care medicine business |
| Zdroj: | Current epidemiology reports |
| ISSN: | 2196-2995 |
| DOI: | 10.1007/s40471-021-00264-7 |
| Popis: | Purpose of Review To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL). Recent Findings We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications. Tools such as STOPPFrail, OncPal, and the Unnecessary Drug Use Measure can facilitate deprescribing. Outcome measures vary and selection of measures should align with the operationalized deprescribing definition used by study investigators. Summary EOL deprescribing considerations include medication appropriateness in the context of patient goals for care, expected benefit from medication given life expectancy, and heightened potential for medication-related harm as death nears. Additional data are needed on how EOL deprescribing impacts patient quality of life, caregiver burden, and out-of-pocket medication-related costs to patients and caregivers. Investigators should design deprescribing studies with this information in mind. |
| Databáze: | OpenAIRE |
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