Deprescribing: Future directions for research

被引:48
|
作者
Thompson, Wade [1 ]
Reeve, Emily [2 ,3 ,4 ,5 ]
Moriarty, Frank [6 ]
Maclure, Malcolm [7 ]
Turner, Justin [8 ,11 ]
Steinman, Michael A. [9 ]
Conklin, James [10 ]
Dolovich, Lisa [12 ,13 ]
McCarthy, Lisa [12 ,14 ,15 ]
Farrell, Barbara [10 ,16 ,17 ]
机构
[1] Univ Southern Denmark, Dept Publ Hlth, Res Unit Gen Practice, JB Winslowsvej 9A, DK-5000 Odense C, Denmark
[2] Univ Sydney, Fac Med & Hlth, Northern Clin Sch,Royal North Shore Hosp, NHMRC Cognit Decline Partnership Ctr,Kolling Inst, St Leonards, NSW 2065, Australia
[3] Dalhousie Univ, Fac Med, Geriatr Med Res, Halifax, NS, Canada
[4] Dalhousie Univ, Coll Pharm, Halifax, NS, Canada
[5] Nova Scotia Hlth Author, Halifax, NS, Canada
[6] Royal Coll Surgeons Ireland, HRB Ctr Primary Care Res, 123 St Stephens Green, Dublin D02 YN77, Ireland
[7] Univ British Columbia, Dept Anesthesiol Pharmacol & Therapeut, 2775 Laurel St, Vancouver, BC V5Z 1M9, Canada
[8] Univ Montreal, Ctr Rech, Inst Univ Geriatrie Montreal, 4545 Chemin Queen Mary, Montreal, PQ H3W 1W4, Canada
[9] Univ Calif San Francisco, Dept Med, Div Geriatr, 4150 Clement St,Box 181G, San Francisco, CA 94121 USA
[10] Bruyere Res Inst, Ottawa, ON, Canada
[11] Concordia Univ, Montreal, PQ, Canada
[12] Univ Toronto, Leslie Dan Fac Pharm, 144 Coll St, Toronto, ON M5S 3M2, Canada
[13] McMaster Univ, Dept Family Med, Hamilton, ON, Canada
[14] Womens Coll Hosp, Womens Coll Res Inst, 76 Grenville St, Toronto, ON M5S 1B2, Canada
[15] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada
[16] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada
[17] Univ Waterloo, Sch Pharm, Kitchener, ON, Canada
来源
关键词
Deprescribing; Guidelines; Polypharmacy; Research; TRIALS; HEALTH; OLDER; POLYPHARMACY; PEOPLE; IMPACT;
D O I
10.1016/j.sapharm.2018.08.013
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
A World Cafe workshop was held at the Bruyere Evidence-Based Deprescribing Guidelines Symposium in March 2018 with 30 participants (researchers, clinicians, policy makers, stakeholders). This workshop explored priorities for future work in the field of deprescribing and deprescribing guidelines through group discussion. The discussions were guided by the following questions: (1) What are deprescribing research priorities (to inform guideline development), (2) What outcome measures are important for developing deprescribing guidelines, and (3) How do we evaluate the implementation and effectiveness of deprescribing guidelines? Discussion from all 3 questions identified 6 main priority areas: (1) conducting high-quality and long-term clinical trials that measure patient-important outcomes, (2) focusing on patient involvement and perspectives, (3) investigating the pharmacoeconomics of deprescribing interventions, (4) understanding deprescribing interventions in different populations, (5) generating evidence on clinical management during deprescribing (e.g. managing adverse drug withdrawal effects, subsequent re-prescribing), and (6) implementing interventions in clinical practice. These topics represent what a group of experienced researchers, clinicians, and stakeholders in the field collectively felt was important to consider for design and implementation of future deprescribing studies. The aim is for these findings to stimulate future discussions and be considered by granting agencies, policy makers, deprescribing research networks, and individual researchers planning future deprescribing studies.
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页码:801 / 805
页数:5
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