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Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults
OBJECTIVES: Approximately 98% of older Americans are simultaneously taking 5—or more—medications to manage at least 2 chronic conditions. Polypharmacy and the use of potentially inappropriate medications (PIMs) are a concern for older adults because they pose a risk for adverse drug events (ADEs), w...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447181/ https://www.ncbi.nlm.nih.gov/pubmed/32809998 http://dx.doi.org/10.1097/PTS.0000000000000747 |
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author | Earl, Tara R. Katapodis, Nicole D. Schneiderman, Stephanie R. Shoemaker-Hunt, Sarah J. |
author_facet | Earl, Tara R. Katapodis, Nicole D. Schneiderman, Stephanie R. Shoemaker-Hunt, Sarah J. |
author_sort | Earl, Tara R. |
collection | PubMed |
description | OBJECTIVES: Approximately 98% of older Americans are simultaneously taking 5—or more—medications to manage at least 2 chronic conditions. Polypharmacy and the use of potentially inappropriate medications (PIMs) are a concern for older adults because they pose a risk for adverse drug events (ADEs), which are associated with emergency department visits and hospitalizations and are an important patient safety priority. We sought to review the evidence of patient safety practices aimed at reducing preventable ADEs in older adults, specifically (i) deprescribing interventions to reduce polypharmacy and (ii) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce PIMs. METHODS: We conducted a systematic review of literature published between 2008 and 2018 that studied examined the effect of these interventions to reduce preventable ADEs in older adults. RESULTS: Twenty-six studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP and the systematic review). The deprescribing interventions involved decision support tools, educational interventions, and medication reviews by pharmacists and/or providers. Deprescribing studies primarily examined the effect of interventions on process outcomes and observed reductions in polypharmacy, often significantly. A few studies also examined clinical and economic outcomes. Studies of the use of the STOPP screening criteria most commonly reported changes in PIMs, as well as some economic outcomes. CONCLUSIONS: Deprescribing interventions and interventions using the STOPP criteria seem effective in reducing polypharmacy and PIMs in older adults, respectively. Future research on the effectiveness of these approaches on clinical outcomes, the comparative effectiveness of different multicomponent interventions using these approaches, and how to most effectively implement them to improve uptake and evidence-based care is needed. |
format | Online Article Text |
id | pubmed-7447181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-74471812020-09-11 Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults Earl, Tara R. Katapodis, Nicole D. Schneiderman, Stephanie R. Shoemaker-Hunt, Sarah J. J Patient Saf Review Articles OBJECTIVES: Approximately 98% of older Americans are simultaneously taking 5—or more—medications to manage at least 2 chronic conditions. Polypharmacy and the use of potentially inappropriate medications (PIMs) are a concern for older adults because they pose a risk for adverse drug events (ADEs), which are associated with emergency department visits and hospitalizations and are an important patient safety priority. We sought to review the evidence of patient safety practices aimed at reducing preventable ADEs in older adults, specifically (i) deprescribing interventions to reduce polypharmacy and (ii) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce PIMs. METHODS: We conducted a systematic review of literature published between 2008 and 2018 that studied examined the effect of these interventions to reduce preventable ADEs in older adults. RESULTS: Twenty-six studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP and the systematic review). The deprescribing interventions involved decision support tools, educational interventions, and medication reviews by pharmacists and/or providers. Deprescribing studies primarily examined the effect of interventions on process outcomes and observed reductions in polypharmacy, often significantly. A few studies also examined clinical and economic outcomes. Studies of the use of the STOPP screening criteria most commonly reported changes in PIMs, as well as some economic outcomes. CONCLUSIONS: Deprescribing interventions and interventions using the STOPP criteria seem effective in reducing polypharmacy and PIMs in older adults, respectively. Future research on the effectiveness of these approaches on clinical outcomes, the comparative effectiveness of different multicomponent interventions using these approaches, and how to most effectively implement them to improve uptake and evidence-based care is needed. Lippincott Williams & Wilkins 2020-09 2020-08-24 /pmc/articles/PMC7447181/ /pubmed/32809998 http://dx.doi.org/10.1097/PTS.0000000000000747 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Review Articles Earl, Tara R. Katapodis, Nicole D. Schneiderman, Stephanie R. Shoemaker-Hunt, Sarah J. Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title | Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title_full | Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title_fullStr | Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title_full_unstemmed | Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title_short | Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults |
title_sort | using deprescribing practices and the screening tool of older persons’ potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447181/ https://www.ncbi.nlm.nih.gov/pubmed/32809998 http://dx.doi.org/10.1097/PTS.0000000000000747 |
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