Evidence map›Paper›PMID 31156897›Full record

ReviewEuropean journal of hospital pharmacy : science and practice2017

Challenges of deprescribing in the multimorbid patient.

Shane Cullinan, Christina Raae Hansen, Stephen Byrne, Denis O'Mahony, Patricia Kearney, Laura Sahm

Erratum issuedAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in European journal of hospital pharmacy : science and practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

  • Erratum issued
    2017
5 · Who and what money

Authors and funding

6 authors.

Shane CullinanSchool of Pharmacy, University College Cork, Cork, Ireland.
Christina Raae HansenSchool of Pharmacy, University College Cork, Cork, Ireland.
Stephen ByrneSchool of Pharmacy, University College Cork, Cork, Ireland.
Denis O'MahonyDepartment of Geriatric Medicine, Cork University Hospital, Cork, Ireland.
Patricia KearneyDepartment of Epidemiology and Public Health, University College Cork, Cork, Ireland.
Laura SahmSchool of Pharmacy, University College Cork, Cork, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Older patients often have multimorbidity, frequently resulting in polypharmacy. Independently, multimorbidity and polypharmacy are among the biggest risk factors for inappropriate medication, adverse drug reactions, adverse drug events and morbidity, leading to patient harm and hospitalisations. After a medication review, discontinuation of medication or deprescribing is one of the most common recommendations but is likely to be ignored. The deprescribing process includes some or all of the following elements: a review of current medications, identification of medications to be discontinued, a discontinuation regimen, involvement of patients and a review with follow-up. In addition to the complexity presented by prescribing or deprescribing for older multimorbid patients, other factors act as barriers to discontinuation of medications in these patients; these include interprofessional relationships, difficulties with medication reviews, deficiencies in knowledge and evidence and patients' preferences/resistance to change. These challenges are compounded by the need to manage the shared treatment of multiple conditions by several prescribers from different specialties based on disease-specific guidelines without evidence of effects on the older, frailer, multimorbid patients. The interdisciplinary effort in the treatment of such patients needs to improve to ensure that we treat the patient holistically and not just the individual conditions of the multimorbid patient, according to guidelines. We must first, however, equip prescribers to identify instances where deprescribing is appropriate and then make the necessary changes to pharmacotherapy.

Indexed as

DeprescribingInappropriate prescribingMultimorbidityOlder patientPolypharmacy

Identifiers

PMID31156897
PMCPMC6451616

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.