Deprescribing: Future directions for research

被引:53
作者
Thompson, Wade [1 ]
Reeve, Emily [2 ,3 ,4 ,5 ]
Moriarty, Frank [6 ]
Maclure, Malcolm [7 ]
Turner, Justin [8 ,11 ]
Steinman, Michael A. [9 ]
Conklin, James [10 ]
Dolovich, Lisa [12 ,13 ]
McCarthy, Lisa [12 ,14 ,15 ]
Farrell, Barbara [10 ,16 ,17 ]
机构
[1] Univ Southern Denmark, Dept Publ Hlth, Res Unit Gen Practice, JB Winslowsvej 9A, DK-5000 Odense C, Denmark
[2] Univ Sydney, Fac Med & Hlth, Northern Clin Sch,Royal North Shore Hosp, NHMRC Cognit Decline Partnership Ctr,Kolling Inst, St Leonards, NSW 2065, Australia
[3] Dalhousie Univ, Fac Med, Geriatr Med Res, Halifax, NS, Canada
[4] Dalhousie Univ, Coll Pharm, Halifax, NS, Canada
[5] Nova Scotia Hlth Author, Halifax, NS, Canada
[6] Royal Coll Surgeons Ireland, HRB Ctr Primary Care Res, 123 St Stephens Green, Dublin D02 YN77, Ireland
[7] Univ British Columbia, Dept Anesthesiol Pharmacol & Therapeut, 2775 Laurel St, Vancouver, BC V5Z 1M9, Canada
[8] Univ Montreal, Ctr Rech, Inst Univ Geriatrie Montreal, 4545 Chemin Queen Mary, Montreal, PQ H3W 1W4, Canada
[9] Univ Calif San Francisco, Dept Med, Div Geriatr, 4150 Clement St,Box 181G, San Francisco, CA 94121 USA
[10] Bruyere Res Inst, Ottawa, ON, Canada
[11] Concordia Univ, Montreal, PQ, Canada
[12] Univ Toronto, Leslie Dan Fac Pharm, 144 Coll St, Toronto, ON M5S 3M2, Canada
[13] McMaster Univ, Dept Family Med, Hamilton, ON, Canada
[14] Womens Coll Hosp, Womens Coll Res Inst, 76 Grenville St, Toronto, ON M5S 1B2, Canada
[15] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada
[16] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada
[17] Univ Waterloo, Sch Pharm, Kitchener, ON, Canada
关键词
Deprescribing; Guidelines; Polypharmacy; Research; TRIALS; HEALTH; OLDER; POLYPHARMACY; PEOPLE; IMPACT;
D O I
10.1016/j.sapharm.2018.08.013
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
A World Cafe workshop was held at the Bruyere Evidence-Based Deprescribing Guidelines Symposium in March 2018 with 30 participants (researchers, clinicians, policy makers, stakeholders). This workshop explored priorities for future work in the field of deprescribing and deprescribing guidelines through group discussion. The discussions were guided by the following questions: (1) What are deprescribing research priorities (to inform guideline development), (2) What outcome measures are important for developing deprescribing guidelines, and (3) How do we evaluate the implementation and effectiveness of deprescribing guidelines? Discussion from all 3 questions identified 6 main priority areas: (1) conducting high-quality and long-term clinical trials that measure patient-important outcomes, (2) focusing on patient involvement and perspectives, (3) investigating the pharmacoeconomics of deprescribing interventions, (4) understanding deprescribing interventions in different populations, (5) generating evidence on clinical management during deprescribing (e.g. managing adverse drug withdrawal effects, subsequent re-prescribing), and (6) implementing interventions in clinical practice. These topics represent what a group of experienced researchers, clinicians, and stakeholders in the field collectively felt was important to consider for design and implementation of future deprescribing studies. The aim is for these findings to stimulate future discussions and be considered by granting agencies, policy makers, deprescribing research networks, and individual researchers planning future deprescribing studies.
引用
收藏
页码:801 / 805
页数:5
相关论文
共 17 条
[1]  
Brown J., 2005, SHAPING OUR FUTURES
[2]   Economic impact of medication non-adherence by disease groups: a systematic review [J].
Cutler, Rachelle Louise ;
Fernandez-Llimos, Fernando ;
Frommer, Michael ;
Benrimoj, Charlie ;
Garcia-Cardenas, Victoria .
BMJ OPEN, 2018, 8 (01)
[3]   The World Cafe: An innovative method to facilitate reflections on internationalisation in higher education [J].
Estacio, Emee Vida ;
Karic, Toni .
JOURNAL OF FURTHER AND HIGHER EDUCATION, 2016, 40 (06) :731-745
[4]   What Are Priorities for Deprescribing for Elderly Patients? Capturing the Voice of Practitioners: A Modified Delphi Process [J].
Farrell, Barbara ;
Tsang, Corey ;
Raman-Wilms, Lalitha ;
Irving, Hannah ;
Conklin, James ;
Pottie, Kevin .
PLOS ONE, 2015, 10 (04)
[5]  
Farrell N, 2016, ASIA-PAC J HEALTH MA, V11, P8
[6]   Evaluating the public health impact of health promotion interventions: The RE-AIM framework [J].
Glasgow, RE ;
Vogt, TM ;
Boles, SM .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1999, 89 (09) :1322-1327
[7]   Deprescribing Trials: Methods to Reduce Polypharmacy and the Impact on Prescribing and Clinical Outcomes [J].
Gnjidic, Danijela ;
Le Couteur, David G. ;
Kouladjian, Lisa ;
Hilmer, Sarah N. .
CLINICS IN GERIATRIC MEDICINE, 2012, 28 (02) :237-+
[8]   Medication Withdrawal Trials in People Aged 65 Years and Older A Systematic Review [J].
Iyer, Shoba ;
Naganathan, Vasi ;
McLachlan, Andrew J. ;
Le Couteur, David G. .
DRUGS & AGING, 2008, 25 (12) :1021-1031
[9]   Too much medicine in older people? Deprescribing through shared decision making [J].
Jansen, Jesse ;
Naganathan, Vasi ;
Carter, Stacy M. ;
McLachlan, Andrew J. ;
Nickel, Brooke ;
Irwig, Les ;
Bonner, Carissa ;
Doust, Jenny ;
Colvin, Jim ;
Heaney, Aine ;
Turner, Robin ;
McCaffery, Kirsten .
BMJ-BRITISH MEDICAL JOURNAL, 2016, 353
[10]   The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis [J].
Page, Amy T. ;
Clifford, Rhonda M. ;
Potter, Kathleen ;
Schwartz, Darren ;
Etherton-Beer, Christopher D. .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2016, 82 (03) :583-623