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Bužančić I, Držaić M, Kummer I, Ortner Hadžiabdić M, Brkić J, Fialová D. Deprescribing potential of commonly used medications among community-dwelling older adults: insights from a pharmacist's geriatric assessment. Sci Rep 2024; 14:6235. [PMID: 38485992 PMCID: PMC10940601 DOI: 10.1038/s41598-024-56780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Pharmacist's geriatric assessment can provide valuable insights into potential deprescribing targets, while including important information on various health-related domains. Data collected from a geriatric assessment questionnaire, for 388 patients, from the Croatian cohort of the EuroAgeism H2020 ESR 7 international project, along with guideline-based deprescribing criteria, were used to analyse potentially inappropriate prescribing of four medication groups (benzodiazepines (BZN), proton pump inhibitors (PPI), opioids, and non-steroidal anti-inflammatory drugs (NSAID)), and to assess the deprescribing potential. Binary logistic regression was used to explore the effects of age, gender, number of medicines and diagnoses, self-reported health, frailty score, and healthcare utilization on the likelihood of needing deprescribing. More than half of participants (n = 216, 55.2%) are candidates for deprescribing, with 31.1% of PPI, 74.8% of NSAID, 75% of opioid, and 96.1% of BZN users meeting at least one criterion. Most common criteria for deprescribing were inappropriately long use and safety concerns. Women (aOR = 2.58; p < 0.001), those reporting poor self-reported health (aOR = 5.14; p < 0.001), and those exposed to polypharmacy (aOR = 1.29; p < 0.001) had higher odds of needing to have medicines deprescribed. The high rate of deprescribing potential warrants prompt action to increase patient safety and decrease polypharmacy. Pharmacist's geriatric assessment and deprescribing-focused medication review could be used to lead a personalised approach.
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Affiliation(s)
- Iva Bužančić
- City Pharmacies Zagreb, Kralja Držislava 6, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia
| | - Margita Držaić
- City Pharmacies Zagreb, Kralja Držislava 6, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia
| | - Ingrid Kummer
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
| | - Maja Ortner Hadžiabdić
- Faculty of Pharmacy and Biochemistry, Center for Applied Pharmacy, University of Zagreb, Ante Kovačića 1, 10 000, Zagreb, Croatia.
| | - Jovana Brkić
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 450 Vojvode Stepe Street, Belgrade, Serbia
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, Hradec Králové, Prague, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine in Prague, Charles University, Kateřinská 32, Prague, Czech Republic
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Lundby C, Thompson W. Advancing deprescribing: Learnings from the first international conference on deprescribing. Basic Clin Pharmacol Toxicol 2024; 134:3-5. [PMID: 37984365 DOI: 10.1111/bcpt.13963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Carina Lundby
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Wade Thompson
- Department of Anaesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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