Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study

6533b852fe1ef96bd12aabdb

RESEARCH PRODUCT

Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study

L. Pasina B. B. Ottolini L. Cortesi M. Tettamanti C. Franchi A. Marengoni P. M. Mannucci A. Nobili S. Corrao F. Salerno M. Cesari F. Perticone G. Licata F. Violi G. R. Corazza I. Ardoino D. Prisco E. Silvestri C. Cenci G. Emmi G. Biolo M. Zanetti M. Guadagni M. Zaccari M. Vanoli G. Grignani E. A. Pulixi M. Bernardi S. L. Bassi L. Santi G. Zaccherini E. Mannarino G. Lupattelli V. Bianconi F. Paciullo R. Nuti R. Valenti M. Ruvio S. Cappelli A. Palazzuoli O. Olivieri D. Girelli T. Matteazzi M. Barbagallo L. Dominguez F. Cocita V. Beneduce L. Plances M. Zoli I. Lazzari M. Brunori F. L. Pasini P. L. Capecchi G. Palasciano M. E. Modeo C. Di Gennaro M. D. Cappellini D. Maira V. Di Stefano G. Fabio S. Seghezzi M. Mancarella P. D. Rossi S. Damanti M. Clerici F. Conti E. Miceli M. V. Lenti M. Pisati C. C. Dominioni G. Murialdo A. Marra F. Cattaneo M. B. Secchi D. Ghelfi L. Anastasio L. Sofia M. Carbone F. Cipollone M. T. Guagnano E. Angelucci E. Valeriani G. Mancuso D. Calipari M. Bartone G. Delitala M. Berria M. Muscaritoli A. Molfino E. Petrillo G. Zuccala G. D'aurizio G. Romanelli A. Zucchelli A. Picardi U. V. Gentilucci P. Gallo C. Dell'unto G. Annoni M. Corsi G. Bellelli S. Zazzetta P. Mazzola H. Szabo A. Bonfanti F. Arturi E. Succurro M. Rubino M. G. Serra M. A. Bleve L. Gasbarrone M. R. Sajeva A. Brucato S. Ghidoni F. Fabris I. Bertozzi G. Bogoni M. V. Rabuini E. Cosi R. Manfredini F. Fabbian B. Boari A. De Giorgi R. Tiseo G. Paolisso M. R. Rizzo C. Borghi E. Strocchi V. De Sando I. Pareo C. Sabba F. S. Vella P. Suppressa P. Agosti A. Schilardi F. Loparco L. Fenoglio C. Bracco A. V. Giraudo S. Fargion G. Periti M. Porzio S. Tiraboschi F. Peyvandi R. Rossio B. Ferrari G. Colombo V. Monzani V. Savojardo C. Folli G. Ceriani G. Pallini F. Dallegri L. Ottonello L. Liberale L. Caserza K. Salam N. L. Liberato T. Tognin G. B. Bianchi S. Giaquinto F. Purrello A. Di Pino S. Piro R. Rozzini L. Falanga E. Spazzini C. Ferrandina G. Montrucchio P. Petitti R. Salmi P. Gaudenzi L. Perri R. Landolfi M. Montalto A. Mirijello L. Guasti L. Castiglioni A. Maresca A. Squizzato M. Molaro A. Grossi M. Bertolotti C. Mussi M. V. Libbra G. Dondi E. Pellegrini L. Carulli L. Colangelo T. Falbo V. Stanghellini R. De Giorgio E. Ruggeri S. Del Vecchio A. Salvi R. Leonardi G. Damiani A. Gabrielli W. Capeci M. Mattioli G. P. Martino L. Biondi P. Pettinari R. Ghio A. Dal Col S. Minisola L. Colangelo A. Afeltra B. Marigliano M. E. Pipita P. Castellino J. Blanco L. Zanoli S. Pignataro V. Saracco M. Fogliati C. Bussolino F. Mete M. Gino A. Cittadini C. Vigorito M. Arcopinto A. Salzano E. Bobbio A. M. Marra D. Sirico G. Moreo F. Gasparini S. Prolo G. Pina A. Ballestrero F. Ferrando S. Berra S. Dassi M. C. Nava B. Graziella S. Baldassarre S. Fragapani G. Gruden G. Galanti G. Mascherini C. Petri L. Stefani M. Girino V. Piccinelli F. Nasso V. Gioffre M. Pasquale G. Scattolin S. Martinelli M. Turrin L. Sechi C. Catena G. Colussi N. Passariello L. Rinaldi F. Berti G. Famularo T. Patrizia R. Castello M. Pasino G. P. Ceda M. G. Maggio S. Morganti A. Artoni S. Del Giacco D. Firinu F. Losa G. Paoletti G. Montalto A. Licata V. Malerba L. Antonino G. Basile C. Antonino L. Malatino B. Stancanelli V. Terranova S. Di Marca P. Mecocci C. Ruggiero V. Boccardi T. Meschi F. Lauretani A. Ticinesi P. Minuz L. Fondrieschi M. Pirisi G. P. Fra D. Sola M. Porta P. Riva R. Quadri G. Scanzi C. Mengoli S. Provini L. Ricevuti E. Simeone R. Scurti F. Tolloso R. Tarquini A. Valoriani S. Dolenti G. Vannini A. Tedeschi L. Trotta R. Volpi P. Bocchi A. Vignali S. Harari C. Lonati M. Cattaneo N. R. Duque A. M. Molinero P. A. Requejo V. L. Pelaez L. Tamargo X. C. Viros F. Formiga J. D. Manglano E. B. Tello E. Del Corral Behamonte M. S. Puras M. Romero B. P. Llorente C. L. Gonzalez-cobos M. Victoria Villalba Garcia S. Lopez J. Bosco S. S. Baena M. A. Gallego C. G. Becerra A. F. Moyano M. G. Hernandez M. P. Borrego R. P. Cuadros F. P. Rojas B. G. Olid S. C. Garcia A. G. -C. Cervellera M. P. Martinez A. R. Cantero A. A. Arraigosa M. G. Guerrero M. A. B. Ramos M. J. Manuel I. N. Veleiro L. A. Suarez A. Lopez D. R. Bran I. I. Vazquez M. R. Prego

subject

0301 basic medicine Drug Male medicine.medical_specialty Deprescriptions 020205 medical informatics Drug-Related Side Effects and Adverse Reactions media_common.quotation_subject Elderly; End of life; Limited life expectancy; Polypharmacy; Symptomatic medications; Aged 80 and over; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Italy; Male; Polypharmacy; Deprescriptions; Life Expectancy; Patient Discharge Socio-culturale 02 engineering and technology 03 medical and health sciences Elderly · End of life · Limited life expectancy · Polypharmacy · Symptomatic medications Pharmacotherapy Deprescriptions Life Expectancy Elderly Symptomatic medications 0202 electrical engineering electronic engineering information engineering medicine 80 and over Humans LS4_4 Medical prescription Elderly; End of life; Limited life expectancy; Polypharmacy; Symptomatic medications media_common Aged Polypharmacy Aged 80 and over Original Paper business.industry General Medicine Elderly End-of-life Limited life expectancy Polypharmacy Preventing medications Symptomatic medications Elderly End of life Limited life expectancy Polypharmacy Symptomatic medications Patient Discharge Clonidine Limited life expectancy Italy Emergency medicine End of life Life expectancy Polypharmacy Female 030101 anatomy & morphology Deprescribing business medicine.drug Symptomatic medication

description

Objective: Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). Materials and Methods: We analyzed Registry of Polytherapies Societa Italiana di Medicina Interna (REPOSI), a network of internal medicine and geriatric wards, to describe the drug therapy of patients discharged with a limited life expectancy. Results: The study sample comprised 55 patients discharged with a limited life expectancy. Patients with at least 1 preventive medication that could be considered for deprescription at the end of life were significantly fewer from admission to discharge (n = 30; 54.5% vs. n = 21; 38.2%; p = 0.02). Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, lipid-lowering drugs, and clonidine were the most frequent potentially avoidable medications prescribed at discharge, followed by xanthine oxidase inhibitors and drugs to prevent fractures. Thirty-seven (67.3%) patients were also exposed to at least 1 potentially severe DDI at discharge. Conclusion: Hospital discharge is associated with a small reduction in the use of commonly prescribed preventive medications in patients discharged with a limited life expectancy. Cardiovascular drugs are the most frequent potentially avoidable preventive medications. A consensus framework or shared criteria for potentially inappropriate medication in elderly patients with limited life expectancy could be useful to further improve drug prescription.

year	journal	country	edition	language
2019-03-20

10.1159/000499692 http://hdl.handle.net/11392/2411109