Deprescribing against polypragmasia: possibilities of the method


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Abstract

A scientific review on methodology of deprescribing in elderly patients with polypragmasia is presented. Deprescribing involves the cancellation or reduction of dosages of medicines (drugs), which have become inappropriate or have lost their justification for use with the duration of treatment of elderly patients. Deprescribing is not a refusal to prescribe an effective drug, but a positive patient-oriented intervention that requires collaborative decision-making, informed patient consent and careful monitoring of effects based on the principles of high-quality drug prescription. Deprescribing is aimed at reducing the frequency of side effects associated with the use of drugs, improving functional status and preventing premature mortality. In addition, deprescribing can reduce the drug burden in the patient, and improve adherence to pharmacotherapy. The review includes evidence-based medicine data, including meta-analyzes of clinical and observational cohort studies, including for specific pharmacological classes of drugs - psychotropic agents, proton pump inhibitors, antihypertensives, statins, as well as data on deprescribing in the inpatient sector. In many cases, deprecibing can improve the condition and quality of life of patients, as well as outcomes. The methodology of deprecibing has widely accepted; guidelines and algorithms have been prepared, conferences are held.

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About the authors

M. V Leonova

All-Russian Association of Clinical Pharmacologists

Email: anti23@mail.iu
MD, Professor, Corresponding Member of RANS, Clinical Pharmacologist

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