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HCCIntelligence™ Webinar Recording: Medication Man ...
Deprescribing Algorithm Guidelines
Deprescribing Algorithm Guidelines
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Pdf Summary
The document titled "Guidelines for Deploying a Deprescribing Algorithm" by the Home Centered Care Institute focuses on identifying and managing inappropriate medication use in elderly patients, typically over the age of 65. As the body ages, changes such as decreased muscle mass, increased body fat, and reduced organ function can impact how medications are metabolized, necessitating careful evaluation on a case-by-case basis.<br /><br />The key points include:<br /><br />1. **Physiological Changes and Medication Impact:** Aging leads to significant changes that can affect drug metabolism, such as a decrease in body water and muscle mass and an increase in body fat.<br /><br />2. **Inappropriate Medication Use:** This includes under-prescribing, over-prescribing, mis-prescribing, prescribing the wrong dose or drug, and drug-drug interactions. Special attention should be given after hospitalizations or specialist visits.<br /><br />3. **Tools for Deprescribing:**<br /> - The Beers Criteria, developed by geriatricians and updated by the American Geriatrics Society, provides evidence-based guidelines on drugs to avoid in the elderly.<br /> - Medications are categorized based on their potential harm and necessity, including those that should be avoided in most older adults, those with specific health conditions, and those that require caution or adjusted dosing based on renal function.<br /><br />4. **Steps to De-escalate Medication Use:**<br /> - **Step 1:** Identify issues with current medications, including over-the-counter drugs and supplements.<br /> - **Step 2:** Evaluate overall medication risk using clinical guidelines.<br /> - **Step 3:** Assess the necessity of each drug.<br /> - **Step 4:** Prioritize discontinuing drugs that pose the greatest harm or are easiest to stop.<br /> - **Step 5:** Implement and monitor the discontinuation process, considering the need for tapering dosages to avoid withdrawal.<br /><br />5. **Considerations for Specific Drug Categories:** <br /> - **Benzodiazepines:** Often tapered due to dependency risks.<br /> - **Antihypertensives and Statins:** May need assessment for discontinuation based on individual benefits and risks.<br /> - **Warfarin and NSAIDs:** Require careful dosage adjustments or tapering based on patient condition.<br /> - **Acid Suppressants:** Tapering is recommended to prevent rebound hypersecretion.<br /><br />In summary, effective deprescribing involves a systematic approach to identifying and discontinuing unnecessary or harmful medications in elderly patients, utilizing tools like the Beers Criteria and following specific procedural steps for safe medication reduction.
Keywords
Deprescribing Algorithm
Elderly Medication Management
Beers Criteria
Physiological Changes
Inappropriate Medication Use
Drug Metabolism
Medication Risk Evaluation
Tapering Dosages
Drug-Drug Interactions
Home Centered Care Institute
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