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Deprescribing
Deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient's current situation. Deprescribing can help correct polypharmacy and prescription cascade. Deprescribing is often done with people who have multiple chronic conditions, for older people, and for people who have a limited life expectancy. In all of these situations, certain medications may contribute to an increased risk of adverse events, and people may benefit from a reduction in the amount of medication taken. The goal of deprescribing is to reduce medication burden and harm, while maintaining or improving quality of life. "Simply because a patient has tolerated a therapy for a long duration does not mean that it remains an appropriate tre ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Polypharmacy
Polypharmacy (polypragmasia) is the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs.Taghy N, Cambon L, Cohen JM, Dussart C. Failure to Reach a Consensus in Polypharmacy Definition: An Obstacle to Measuring Risks and Impacts—Results of a Literature Review. ''Ther Clin Risk Manag.'' 2020;16:57-73 https://doi.org/10.2147/TCRM.S214187 Polypharmacy is often the consequence of having multiple long-term conditions, also known as multimorbidity. An excessive number of medications is worrisome, especially for older patients with many chronic health conditions, because this increases the risk of an adverse event in those patients. The prevalence of polypharmacy is estimated to be between 10% and 90% depending on the definition used, the age group studied, and the geographic location. Polypharmacy continues to grow ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Polypharmacy
Polypharmacy (polypragmasia) is the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs.Taghy N, Cambon L, Cohen JM, Dussart C. Failure to Reach a Consensus in Polypharmacy Definition: An Obstacle to Measuring Risks and Impacts—Results of a Literature Review. ''Ther Clin Risk Manag.'' 2020;16:57-73 https://doi.org/10.2147/TCRM.S214187 Polypharmacy is often the consequence of having multiple long-term conditions, also known as multimorbidity. An excessive number of medications is worrisome, especially for older patients with many chronic health conditions, because this increases the risk of an adverse event in those patients. The prevalence of polypharmacy is estimated to be between 10% and 90% depending on the definition used, the age group studied, and the geographic location. Polypharmacy continues to grow ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medication Discontinuation
Medication discontinuation is the ceasing of a medication treatment for a patient by either the clinician or the patient themself. When initiated by the clinician, it is known as deprescribing. Medication discontinuation is an important medical practice that may be motivated by a number of reasons: * Reducing polypharmacy * Reducing health expenditure * Improving quality of life by ceasing medications with potential adverse effects or where the indication for a medical treatment may have changed * Reflect changes in evidence that support a treatment * Reflecting changes in treatment goals, such as a move to end-of-life care. Unlike the prescribing of medications, appropriate discontinuation has not attracted nearly as much attention or interest. End-of-life care Medications may be stopped in the context of end-of-life care, such as medications that may affect risk factors for future disease. Medications that may be stopped as part of discussions about end-of-life care inclu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Prescription Cascade
Prescription cascade is the process whereby the side effects of drugs are misdiagnosed as symptoms of another problem, resulting in further prescriptions and further side effects and unanticipated drug interactions, which itself may lead to further symptoms and further misdiagnoses. This is a pharmacological example of a feedback loop. Such cascades can be reversed through deprescribing. Theory Over the past 20 years, spending on prescription drugs has increased drastically. This can be attributed to several different situations: There is the increased diagnosis of chronic conditions; and the use of numerous medications by the older population; and an increase in the incidence of obesity has meant an increase in chronic conditions such as diabetes and hypertension. As each condition is treated with a specific drug, a correlating side-effect of each drug comes into play. If a doctor fails to acknowledge all the drugs that a patient is taking, an adverse drug reaction may be misinter ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Prescription Cascade
Prescription cascade is the process whereby the side effects of drugs are misdiagnosed as symptoms of another problem, resulting in further prescriptions and further side effects and unanticipated drug interactions, which itself may lead to further symptoms and further misdiagnoses. This is a pharmacological example of a feedback loop. Such cascades can be reversed through deprescribing. Theory Over the past 20 years, spending on prescription drugs has increased drastically. This can be attributed to several different situations: There is the increased diagnosis of chronic conditions; and the use of numerous medications by the older population; and an increase in the incidence of obesity has meant an increase in chronic conditions such as diabetes and hypertension. As each condition is treated with a specific drug, a correlating side-effect of each drug comes into play. If a doctor fails to acknowledge all the drugs that a patient is taking, an adverse drug reaction may be misinter ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Beers Criteria
The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribing medications for adults 65 years and older in all except palliative settings. They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and adverse drug reactions, thereby improving the risk–benefit ratio of medication regimens in at-risk people. The criteria are used in geriatrics clinical care to monitor and improve the quality of care. They are also used in training, research, and healthcare policy to assist in developing performance measures and document outcomes. These criteria include lists of medications in which the potential risks may be greater than the potential benefits for people 65 and older. By considering this information, practitioners may be ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Beers Criteria
The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribing medications for adults 65 years and older in all except palliative settings. They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and adverse drug reactions, thereby improving the risk–benefit ratio of medication regimens in at-risk people. The criteria are used in geriatrics clinical care to monitor and improve the quality of care. They are also used in training, research, and healthcare policy to assist in developing performance measures and document outcomes. These criteria include lists of medications in which the potential risks may be greater than the potential benefits for people 65 and older. By considering this information, practitioners may be ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management. Drugs are classified in multiple ways. One of the key divisions is by level of control, which distinguishes prescription drugs (those that a pharmacist dispenses only on the order of a physician, physician assistant, or qualified nurse) from over-the-counter drugs (those that consumers can order for themselves). Another key distinction is between traditional small molecule drugs, usually derived from chemical synthesis, and biopharmaceuticals, which include recombinant proteins, vaccines, blood products used therapeutically (such as IVIG), gene therapy, monoclonal antibodies and cell therapy (for instance, stem cell therapies) ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Long-term Care
Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time. It is common for long-term care to provide custodial and non-skilled care, such as assisting with activities of daily living like dressing, feeding, using the bathroom, meal preparation, functional transfers and safe restroom use. Increasingly, long-term care involves providing a level of medical care that requires the expertise of skilled practitioners to address the multiple long-term conditions associated with older populations. Long-term care can be provided at home, in the community, in assisted living facilities or in nursing homes. Long-term care may be needed by people of any age, although it is a m ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Geriatrics
Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of older adults. The term ''geriatrics'' originates from the Greek language, Greek γέρων ''geron'' meaning "old man", and ιατρός ''iatros'' meaning "healer". It aims to promote health by prevention (medical), preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of elderly people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently. ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pharmaceuticals Policy
Pharmaceutical policy is a branch of health policy that deals with the development, provision and use of medications within a health care system. It embraces drugs (both brand name and generic), biologics (products derived from living sources, as opposed to chemical compositions), vaccines and natural health products. Funding of research in the life sciences In many countries, an agency of the national government (in the U.S. the NIH, in the U.K. the MRC, and in India the DST) funds university researchers to study the causes of disease, which in some cases leads to the development of discoveries which can be transferred to pharmaceutical companies and biotechnology companies as a basis for drug development. By setting its budget, its research priorities and making decisions about which researchers to fund, there can be a significant impact on the rate of new drug development and on the disease areas in which new drugs are developed. For example, a major investment by the NIH into ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Drug Interaction
Drug interactions occur when a drug's mechanism of action is disturbed by the concomitant administration of substances such as foods, beverages, or other drugs. The cause is often the inhibition of the specific receptors available to the drug, forcing the drug molecules to bind to other non-intended targets which results in an array of side-effects. The term selectivity describes a drug’s ability to target a single receptor, rendering a predictable physiological response. For example, the binding of acetylcholine to muscarinic tracheal smooth-muscle receptors (M3) results in smooth muscle contractions. When free receptors become occupied by agonists - drugs that bind and activate receptors - and antagonists - drugs that inhibit/ block activation - the opportunity for drugs to target their intended receptor decreases as most receptors are already occupied. Therefore, when the number of free receptors decreases, the drugs begin binding to other secondary receptors, causing s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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