Deprescribing in Older Adults With Cardiovascular Disease

Geriatric Cardiology Section Leadership Council, American College of Cardiology

Research output: Contribution to journalReview article

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 languageEnglish (US)
Pages (from-to)2584-2595
Number of pages12
JournalJournal of the American College of Cardiology
Volume73
Issue number20
DOIs
StatePublished - May 28 2019

Fingerprint

Polypharmacy
Cardiovascular Diseases
Patient Care Planning
Life Expectancy
Drug-Related Side Effects and Adverse Reactions
Practice Guidelines
Geriatrics
Costs and Cost Analysis
Deprescriptions

Keywords

  • deprescribing
  • geriatrics
  • medications
  • multimorbidity
  • multiple chronic conditions
  • older adults
  • polypharmacy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Geriatric Cardiology Section Leadership Council, American College of Cardiology (2019). Deprescribing in Older Adults With Cardiovascular Disease. Journal of the American College of Cardiology, 73(20), 2584-2595. https://doi.org/10.1016/j.jacc.2019.03.467

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 journalReview article

Geriatric Cardiology Section Leadership Council, American College of Cardiology 2019, 'Deprescribing in Older Adults With Cardiovascular Disease', Journal of the American College of Cardiology, vol. 73, no. 20, pp. 2584-2595. https://doi.org/10.1016/j.jacc.2019.03.467
Geriatric Cardiology Section Leadership Council, American College of Cardiology. Deprescribing in Older Adults With Cardiovascular Disease. Journal of the American College of Cardiology. 2019 May 28;73(20):2584-2595. https://doi.org/10.1016/j.jacc.2019.03.467
Geriatric Cardiology Section Leadership Council, American College of Cardiology. / Deprescribing in Older Adults With Cardiovascular Disease. In: Journal of the American College of Cardiology. 2019 ; Vol. 73, No. 20. pp. 2584-2595.
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