Deprescribing in older people approaching end-of-life: development and validation of STOPPFrail version 2
Deprescribing in older people approaching end-of-life: development and validation of STOPPFrail version 2
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DOI：
10.1093/ageing/afaa159
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发表时间：
2021-03-01
期刊：
影响因子：
6.7
通讯作者：
O'Mahony, Denis
中科院分区：
文献类型：
--
作者：
Curtin, Denis;Gallagher, Paul;O'Mahony, Denis
工作背景：2017年制定了预期寿命有限的虚弱成人处方筛选工具（STOPPFrail）标准，以帮助医生在接近生命终结的老年人中做出取消处方的决定。需要更新，使工具更实用，以病人为中心，complete.Methods：进行了彻底的文献综述，第一，制定一个实用的方法来确定老年人谁是可能接近生命的尽头，第二，重新评估和更新现有的开药标准。一个在老年药物治疗方面具有广泛经验的八人小组审查了一份新的STOPPFrail草案，并被邀请提出新的取消处方标准。然后使用德尔菲共识methodology.Results：STOPPFrail第2版进行验证：STOPPFrail第2版强调共同决策的重要性，在开处方的过程。一种新的方法来确定老年人谁是可能接近生命的尽头是包括沿着与25个取消标准。指南有关的开处方的抗高血压治疗，抗心绞痛药物和维生素D制剂包括新的criteria.Conclusions：STOPPFrail标准已更新，以协助医生努力减少药物相关的发病率和负担，为他们最脆弱的老年患者。第2版是基于最新的文献综述和专家小组的共识验证。
Background: Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria were developed in 2017 to assist physicians with deprescribing decisions in older people approaching end-of-life. Updating was required to make the tool more practical, patient-centred and complete.Methods: a thorough literature review was conducted to, first, devise a practical method for identifying older people who are likely to be approaching end-of-life, and second, reassess and update the existing deprescribing criteria. An eight-member panel with a wide-ranging experience in geriatric pharmacotherapy reviewed a new draft of STOPPFrail and were invited to propose new deprescribing criteria. STOPPFrail version 2 was then validated using Delphi consensus methodology.Results: STOPPFrail version 2 emphasises the importance of shared decision-making in the deprescribing process. A new method for identifying older people who are likely to be approaching end-of-life is included along with 25 deprescribing criteria. Guidance relating to the deprescribing of antihypertensive therapies, anti-anginal medications and vitamin D preparations comprises the new criteria.Conclusions: STOPPFrail criteria have been updated to assist physicians in efforts to reduce drug-related morbidity and burden for their frailest older patients. Version 2 is based on an up-to-date literature review and consensus validation by a panel of experts.