Discontinuing medications: A novel approach for revising the prescribing stage of the medication-use process

被引:148
作者
Bain, Kevin T. [1 ,2 ,3 ]
Holmes, Holly M. [4 ]
Beers, Mark H. [2 ,3 ,5 ]
Maio, Vittorio [6 ]
Handler, Steven M. [7 ,8 ]
Pauker, Stephen G. [9 ]
机构
[1] Omnicare Co, ExcelleRx Inc, Dept Qual Outcomes, Philadelphia, PA 19102 USA
[2] Univ Sci Philadelphia, Dept Hlth Policy, Philadelphia, PA USA
[3] Baylor Coll Med, Dept Med, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Gen Internal Med Ambulatory Treatment & Emer, Houston, TX 77030 USA
[5] Univ Miami, Miller Sch Med, Miami, FL 33136 USA
[6] Thomas Jefferson Univ, Jefferson Med Coll, Dept Hlth Policy, Philadelphia, PA 19107 USA
[7] Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA USA
[8] Univ Pittsburgh, Sch Med, Dept Biomed Informat, Pittsburgh, PA USA
[9] Tufts Univ, Sch Med, Tufts Med Ctr, Div Clin Decis Making,Dept Med, Boston, MA 02111 USA
基金
美国国家卫生研究院;
关键词
discontinuing medications; drug withdrawal; medication-use process; adverse drug withdrawal events; older adults;
D O I
10.1111/j.1532-5415.2008.01916.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Thousands of Americans are Injured or die each year from adverse drug reactions, many of which are preventable. The burden of harm conveyed by the use of medications is a significant public health problem, and therefore, improving the medication process Is a priority. Recent and ongoing efforts to improve the medication-use process have focused primarily on improving medication prescribing, and not much emphasis has been put on improving medication discontinuation. A formalized approach for rationally discontinuing medications is a necessary antecedent to improving medication safety and improving the nation's quality of care. This article proposes a conceptual framework for revising the prescribing stage of the medication-use process to Include discontinuing, medications. This framework has substantial practice and research implications, especially for the clinical care of older persons, who are particularly susceptible to the adverse effects of medications.
引用
收藏
页码:1946 / 1952
页数:7
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