A concept analysis of deprescribing medications in older people.

Abstract: Aim: Deprescribing is an increasingly common term in the literature, although no specific accepted definition exists. We aimed to clarify the concept of deprescribing as used in research and clinical practice. Methods: Deprescribing was examined using the eight‐step Walker and Avant method...

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Publicado en:Journal of Pharmacy Practice & Research Vol. 48; no. 2; pp. 132 - 149
Autores principales: Page, Amy, Clifford, Rhonda, Potter, Kathleen, Etherton‐Beer, Christopher
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2018
      vid: 48
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/jppr.1361
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        atl: A concept analysis of deprescribing medications in older people.
      aug:
        au:
          Page, Amy
          Clifford, Rhonda
          Potter, Kathleen
          Etherton‐Beer, Christopher
        affil: School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia
      sug:
        subj:
          Concept Analysis
          Inappropriate Prescribing In Old Age
          Human
          Aged
          Patient Centered Care
          Polypharmacy
          Adverse Drug Event
          Outcomes (Health Care)
          Inappropriate Prescribing Mortality
          Aged: 65+ years
      ab: Abstract: Aim: Deprescribing is an increasingly common term in the literature, although no specific accepted definition exists. We aimed to clarify the concept of deprescribing as used in research and clinical practice. Methods: Deprescribing was examined using the eight‐step Walker and Avant method of concept analysis that consisted of: (i) concept selection; (ii) determining the purpose of the analysis; (iii) identifying uses of the concept; (iv) determining the critical attributes; (v) identifying the model case; (vi) identifying borderline and contrary cases; (vii) identifying antecedents and consequences; and (viii) defining empirical referents. A literature search was conducted on the word de?prescri*. Results: We identified seven critical attributes: withdrawing medications, de‐escalation, intended outcomes, structured and iterative process, intervention, risk to benefit, and patient‐centred care. Deprescribing antecedents were identified as changing health, changing goals for health care, and polypharmacy. Deprescribing consequences identified were compliance, health outcomes, mortality and cost, and possibility for adverse drug withdrawal events to occur. We used the model case, borderline and contrary cases and empirical referents to illustrate the concept of deprescribing. Conclusions: Deprescribing is a term used with varying degrees of precision, and there is no accepted definition. In this paper, we have analysed the concept of deprescribing and identified it as a patient‐centred process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required.
      pubtype: Academic Journal
      doctype:
        research
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      ougenre: Article
    language: English
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