Deprescribing medications: Do out-of-pocket costs have a role?
Deprescribing medications: Do out-of-pocket costs have a role?
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DOI：
10.1111/jgs.17974
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发表时间：
2022-11
影响因子：
6.3
通讯作者：
Maciejewski, Matthew L.
中科院分区：
文献类型：
--
作者：
Hung, Anna;Sloan, Caroline E.;Boyd, Cynthia;Bayliss, Elizabeth A.;Hastings, Susan N.;Maciejewski, Matthew L.
V AA uthor Man uscript altogether (ie, cost-related non-adherence, or CRN), as has been shown among patients with multiple chronic conditions. 4, 5 While the introduction of Medicare Part D coverage in 2006 initially reduced CRN among Medicare enrollees from 5.4% to 3.6% across all income levels, CRN has increased in recent years, up to 6.8% in 2017. 4One potential way to reduce medication-related financial burden while at the same time reducing the risk of potentially harmful drug-drug and drug–disease interactions among older patients could be to intentionally consider patients' out-of-pocket (OOP) cost priorities in deprescribing decisions. Deprescribing is defined as discontinuing or reducing the dose of medications for which risks outweigh benefits, that are no longer needed, or that are inconsistent with the goals of care. 6 Currently, clinicians who are considering medications to deprescribe primarily focus on medications that increase a patient's risk of adverse drug events and/or provide little benefit given patient care goals. 7 For example, the American Geriatrics Society Beers Criteria list anticholinergic medications as potentially inappropriate, due to their increased risks of falls and cognitive impairment in older populations. 8 The Screening Tool of Older Persons' Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria recommend against the use of lipid-lowering therapies in patients with poor one-year survival prognosis, due to the long time needed before seeing a benefit. 9 Similarly, the Society for Post-Acute and Long-Term Care Medicine recommends against lipid-lowering therapies and aggressive antihypertensive treatment in patients with limited life expectancy. 10
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DOI：
10.3122/jabfm.2022.02.210360
发表时间：
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影响因子：
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