File(s) not publicly available
Drug cessation in complex older adults: time for action
journal contribution
posted on 2023-06-08, 17:39 authored by Tischa J M van der Cammen, Chakravarthi RajkumarChakravarthi Rajkumar, Graziano Onder, Carolyn S Sterke, Mirko PetrovicBACKGROUND general opinion is growing that drug cessation in complex older patients is warranted in certain situations. From a clinical viewpoint, drug cessation seems most warranted in four situations, i.e., falls, delirium, cognitive impairment and end-of-life situations. To date, little information about the effects of drug cessation in these four situations is available. OBJECTIVES to identify the effects and effectiveness of drug cessation on falls, delirium and cognitive impairment. For end-of-life situations, we reviewed cessation of inappropriate drug use. METHODS electronic databases were searched using MeSH terms and relevant keywords. Studies published in English were included if they evaluated the effects of drug cessation in older persons, aged =65 years, with falls, delirium or cognitive impairment; or cessation of inappropriate drug use in end-of-life situations. RESULTS we selected seven articles for falls, none for delirium, two for cognition and two for end-of-life situations. Withdrawal of psychotropics reduced fall rate; a prescribing modification programme for primary care physicians reduced fall risk. Withdrawal of psychotropics and a systematic reduction of polypharmacy resulted in an improvement of cognition. Very little rigorous research has been conducted on reducing inappropriate medications in patients approaching end of life. CONCLUSION little research has focussed on drug cessation. Available studies showed a beneficial impact of cessation of psychotropic drugs on falls and cognitive status. More research in this field is needed. The issue of systematic drug withdrawal in end-of-life cases is controversial, but is increasingly relevant in the face of rising numbers of older people of this clinical status.
History
Publication status
- Published
Journal
Age and AgeingISSN
0002-0729Publisher
Oxford University PressExternal DOI
Issue
1Volume
43Page range
20-25Department affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2014-06-25Usage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC