Abstract
Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing is particularly applicable to the commonly encountered multimorbid older adult with cardiovascular disease and concomitant geriatric conditions such as polypharmacy, frailty, and cognitive dysfunction—a combination rarely addressed in current clinical practice guidelines. Triggers to deprescribe include present or expected adverse drug reactions, unnecessary polypharmacy, and the need to align medications with goals of care when life expectancy is reduced. Using a framework to deprescribe, this review addresses the rationale, evidence, and strategies for deprescribing cardiovascular and some noncardiovascular medications.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2584-2595 |
| Number of pages | 12 |
| Journal | Journal of the American College of Cardiology |
| Volume | 73 |
| Issue number | 20 |
| DOIs | |
| State | Published - May 28 2019 |
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Keywords
- deprescribing
- geriatrics
- medications
- multimorbidity
- multiple chronic conditions
- older adults
- polypharmacy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Deprescribing in Older Adults With Cardiovascular Disease. / Geriatric Cardiology Section Leadership Council, American College of Cardiology.
In: Journal of the American College of Cardiology, Vol. 73, No. 20, 28.05.2019, p. 2584-2595.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Deprescribing in Older Adults With Cardiovascular Disease
AU - Geriatric Cardiology Section Leadership Council, American College of Cardiology
AU - Krishnaswami, Ashok
AU - Steinman, Michael A.
AU - Goyal, Parag
AU - Zullo, Andrew R.
AU - Anderson, Timothy S.
AU - Birtcher, Kim K.
AU - Goodlin, Sarah
AU - Maurer, Mathew S.
AU - Alexander, Karen P.
AU - Rich, Michael W.
AU - Tjia, Jennifer
PY - 2019/5/28
Y1 - 2019/5/28
N2 - Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing is particularly applicable to the commonly encountered multimorbid older adult with cardiovascular disease and concomitant geriatric conditions such as polypharmacy, frailty, and cognitive dysfunction—a combination rarely addressed in current clinical practice guidelines. Triggers to deprescribe include present or expected adverse drug reactions, unnecessary polypharmacy, and the need to align medications with goals of care when life expectancy is reduced. Using a framework to deprescribe, this review addresses the rationale, evidence, and strategies for deprescribing cardiovascular and some noncardiovascular medications.
AB - Deprescribing, an integral component of a continuum of good prescribing practices, is the process of medication withdrawal or dose reduction to correct or prevent medication-related complications, improve outcomes, and reduce costs. Deprescribing is particularly applicable to the commonly encountered multimorbid older adult with cardiovascular disease and concomitant geriatric conditions such as polypharmacy, frailty, and cognitive dysfunction—a combination rarely addressed in current clinical practice guidelines. Triggers to deprescribe include present or expected adverse drug reactions, unnecessary polypharmacy, and the need to align medications with goals of care when life expectancy is reduced. Using a framework to deprescribe, this review addresses the rationale, evidence, and strategies for deprescribing cardiovascular and some noncardiovascular medications.
KW - deprescribing
KW - geriatrics
KW - medications
KW - multimorbidity
KW - multiple chronic conditions
KW - older adults
KW - polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=85065645809&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065645809&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2019.03.467
DO - 10.1016/j.jacc.2019.03.467
M3 - Review article
VL - 73
SP - 2584
EP - 2595
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 20
ER -