Algorithm of medication review in frail older people: Focus on minimizing the use of high-risk medications

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F16%3A10329207" target="_blank" >RIV/00216208:11110/16:10329207 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1111/ggi.12589" target="_blank" >http://dx.doi.org/10.1111/ggi.12589</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/ggi.12589" target="_blank" >10.1111/ggi.12589</a>

Result language

angličtina

Original language name

Algorithm of medication review in frail older people: Focus on minimizing the use of high-risk medications

Original language description

Aim: Frail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing and avoiding use of high-risk medications might prevent adverse events. The present study aimed to develop a pragmatic, easily applied algorithm for medication review to help clinicians identify and discontinue potentially inappropriate high-risk medications. Methods: The literature was searched for robust evidence of the association of adverse effects related to potentially inappropriate medications in older patients to identify high-risk medications. Prior research into the cessation of potentially inappropriate medications in older patients in different settings was synthesized into a four-step algorithm for incorporation into clinical assessment protocols for patients, particularly those in residential aged care facilities. Results: The algorithm comprises several steps leading to individualized prescribing recommendations: (i) identify a high-risk medication; (ii) ascertain the current indications for the medication and assess their validity; (iii) assess if the drug is providing ongoing symptomatic benefit; and (iv) consider withdrawing, altering or continuing medications. Decision support resources were developed to complement the algorithm in ensuring a systematic and patient-centered approach to medication discontinuation. These include a comprehensive list of high-risk medications and the reasons for inappropriateness, lists of alternative treatments, and suggested medication withdrawal protocols. Conclusions: The algorithm captures a range of different clinical scenarios in relation to potentially inappropriate medications, and offers an evidence-based approach to identifying and, if appropriate, discontinuing such medications. Studies are required to evaluate algorithm effects on prescribing decisions and patient outcomes.

Czech name

—

Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FP - Other medical fields

OECD FORD branch

—

Project

—

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2016

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Geriatrics &amp; Gerontology International

ISSN

1444-1586

e-ISSN

—

Volume of the periodical

16

Issue of the periodical within the volume

9

Country of publishing house

JP - JAPAN

Number of pages

12

Pages from-to

1002-1013

UT code for WoS article

000383674300002

EID of the result in the Scopus database

2-s2.0-84984996462