Deprescribing: A narrative review of the evidence and practical recommendations for recognizing opportunities and taking action.

Abstract:

:Deprescribing can be defined as the process of withdrawal or dose reduction of medications which are considered inappropriate in an individual. The aim of this narrative review is to provide an overview of "deprescribing"; firstly discussing the potential benefits and harms followed by the barriers to and enablers of deprescribing. We also provide practical recommendations to recognise opportunities and strategies for deprescribing in practice. Studies focused on minimizing polypharmacy indicate that deprescribing may be associated with potential benefits including resolution of adverse drug reactions, improved quality of life and medication adherence and a reduction in drug costs. While the data on the benefits is inconsistent, deprescribing appears to be safe. There are, however, potential harms including return of medical conditions or symptoms and adverse drug withdrawal reactions which emphasise the need for the process to be supervised and monitored by a health care professional. Taking action on deprescribing can be facilitated by knowledge of potential barriers, implementing a deprescribing process (utilising developed tools and resources) and identifying opportunities for deprescribing through engaging with patients and caregivers and other health care professionals and considering deprescribing in a variety of populations. Important areas for future research include the suitability of deprescribing of certain medications in specific populations, how to implement deprescribing processes into clinical care in a feasible and cost effective manner and how to engage consumers throughout the process to achieve positive health and quality of life outcomes.

journal_name

Eur J Intern Med

authors

Reeve E,Thompson W,Farrell B

doi

10.1016/j.ejim.2016.12.021

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

3-11

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(16)30450-2

journal_volume

38

pub_type

杂志文章,评审
  • Impact of HCV eradication with direct-acting antiviral agents on serum gamma globulin levels in HCV and HCV/HIV coinfected patients.

    abstract:BACKGROUND:chronic viral infections by both HCV and HIV may lead to polyclonal activation of B cells resulting in hypergammaglobulinemia. This study retrospectively analyzed the effect of HCV eradication with interferon-free direct-acting antiviral agents (DAAs) on the gamma globulin levels in HCV-infected patients wit...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2020.01.006

    authors: Milazzo L,van den Bogaart L,Sollima S,Oreni L,Lai A,Morena V,Bonazzetti C,Ridolfo Anna L,Antinori S

    更新日期:2020-05-01 00:00:00

  • Coronary stent bacterial infection with multiple organ septic emboli.

    abstract::We describe an 80-year-old patient who developed Staphylococcus aureus septicemia several days after the implantation of a double stent in the proximal and mid-left anterior descending artery. The infection was complicated by multiple abscesses in the lungs and liver, as well as by bilateral bacterial endophthalmitis ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2004.10.010

    authors: Hoffman M,Baruch R,Kaplan E,Mittelman M,Aviram G,Siegman-Igra Y

    更新日期:2005-04-01 00:00:00

  • A case of anthracosis presenting with mediastinal lymph nodes mimicking tuberculous lymphadenitis or malignancy.

    abstract::Anthracosis is a form of pneumoconiosis caused by coal dust or by a smoky and polluted environment. Anthracosis often presents in pulmonary form; only rarely are extrathoracic, esophageal, and mediastinal anthracoses documented. We report a rare case of anthracosis with multiple mediastinal lymphadenopathy. ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2003.09.001

    authors: Bilici A,Erdem T,Boysan SN,Acbay O,Oz B,Besirli K,Gundogdu S

    更新日期:2003-11-01 00:00:00

  • Dramatic effect of sirolimus on renal angiomyolipomas in a patient with tuberous sclerosis complex.

    abstract::Angiomyolipomas are very common in patients with tuberous sclerosis complex (TSC) and cause substantial morbidity. Until now, arterial embolization has been the recommended treatment for symptomatic patients. We report the case of a woman with TSC and giant angiolipomas in whom sirolimus induced a dramatic reduction i...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2006.07.017

    authors: Herry I,Neukirch C,Debray MP,Mignon F,Crestani B

    更新日期:2007-01-01 00:00:00

  • First comes the A, then the B: what we learned from the COVID-19 outbreak.

    abstract::The SARS-CoV-2 epidemic, which has spread to many countries around the world, has hit Europe particularly hard. From our point of view, in a rural emergency department (with an annual patient census of around 25,000) in northeastern Italy, it is necessary to preserve the hospital and prevent it from becoming an outbre...

    journal_title:European journal of internal medicine

    pub_type: 信件

    doi:10.1016/j.ejim.2020.06.031

    authors: Copetti R,Amore G,Di Gioia CC,Orso D

    更新日期:2020-10-01 00:00:00

  • Evaluation of a direct test for seasonal influenza in outpatients.

    abstract:OBJECTIVE:To present our experience regarding the use of a rapid diagnostic test for seasonal influenza A and B. METHODS:We systematically collected and analyzed our data regarding the use of a rapid diagnostic test for seasonal influenza A and B in patients with specific respiratory symptoms that sought medical servi...

    journal_title:European journal of internal medicine

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.ejim.2010.06.013

    authors: Theocharis G,Vouloumanou EK,Rafailidis PI,Spiropoulos T,Barbas SG,Falagas ME

    更新日期:2010-10-01 00:00:00

  • The syndrome of rhabdomyolysis: complications and treatment.

    abstract::Rhabdomyolysis is a syndrome of skeletal muscle cell damage that leads to the release of toxic intracellular material into the systemic circulation. The pathogenesis of rhabdomyolysis is based on an increase in free ionized calcium in the cytoplasm. Its main complications include (a) acute renal failure, which is trig...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2007.06.037

    authors: Chatzizisis YS,Misirli G,Hatzitolios AI,Giannoglou GD

    更新日期:2008-12-01 00:00:00

  • Systemic allergic reaction and diffuse bone pain after exposure to a preparation of betamethasone.

    abstract::Allergic reactions to corticosteroids are unexpected as they seem to contradict their pharmacodynamic action. Nevertheless, they are not infrequent, with an estimated incidence of up to 4% for cutaneous reactions. Systemic reactions are rarely reported, but their incidence might be underestimated. We report here an un...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2005.04.004

    authors: Ehret GB,Deluze C,Dayer P,Desmeules JA

    更新日期:2005-12-01 00:00:00

  • Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia.

    abstract:BACKGROUND:Pneumonia with respiratory failure represents the main cause of death in COVID-19, where hyper inflammation plays an important role in lung damage. This study aims to evaluate if tocilizumab, an anti-soluble IL-6 receptor monoclonal antibody, reduces patients' mortality. METHODS:85 consecutive patients admi...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2020.05.009

    authors: Capra R,De Rossi N,Mattioli F,Romanelli G,Scarpazza C,Sormani MP,Cossi S

    更新日期:2020-06-01 00:00:00

  • Hyperhomocysteinemia in bodybuilders taking anabolic steroids.

    abstract::Background: Hyperhomocysteinemia has been accepted as an independent risk factor for atherosclerosis and atherothrombosis. In recent years, several reports have appeared in the literature linking the use of anabolic steroids with acute vascular events in bodybuilders. In this study, we investigated whether hyperhomocy...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/s0953-6205(00)00131-x

    authors: Ebenbichler CF,Kaser S,Bodner J,Gander R,Lechleitner M,Herold M,Patsch JR

    更新日期:2001-02-01 00:00:00

  • Prediction of prognosis to lamivudine in patients with spontaneous reactivation of hepatitis B virus-related acute-on-chronic liver failure: using virologic response at week 4.

    abstract:BACKGROUND/AIMS:Current results had demonstrated lamivudine (LAM) contributed to improve liver function and short-term prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure (ACLF), but data concerning the outcome of long-term prognosis are limited. Our objective was to explore the predicti...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2014.10.007

    authors: Xiang-Hui Y,Lang X,Yan Z,Li Z,Xiao-Feng S,Hong R

    更新日期:2014-11-01 00:00:00

  • Heart failure patients selection for cardiac resynchronization therapy.

    abstract::Cardiac resynchronization therapy (CRT) is an established treatment for refractory chronic heart failure (CHF) patients with ventricular dyssynchrony. The patient selection for this therapy remains the basis for response improvement. Various parameters, methods and technology for identification of appropriate patient ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2010.11.002

    authors: Geng J,Wu B,Zheng L,Zhu J

    更新日期:2011-02-01 00:00:00

  • Outpatient percutaneous liver biopsy: still a good option.

    abstract:OBJECTIVE:To assess security of "blind" percutaneous liver biopsy as an ambulatory procedure. MATERIAL AND METHODS:Defining inclusion criteria, surveillance protocol, data from ultrasonography done 6 h after procedure and complications. RESULTS:We analysed 192 percutaneous liver biopsies done between 2000-2007. There...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2009.02.002

    authors: Pinelo E,Presa J

    更新日期:2009-09-01 00:00:00

  • Heart rate and cardiovascular protection.

    abstract::Recent large epidemiological studies have confirmed that an elevated resting heart rate is an independent predictor of cardiovascular and overall mortality in the general population as well as in patients with hypertension, coronary heart disease and chronic heart failure. Pathophysiological studies indicate that a hi...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2015.02.009

    authors: Caetano J,Delgado Alves J

    更新日期:2015-05-01 00:00:00

  • Arterial stiffness index as a screening test for cardiovascular risk: a comparative study between coronary artery calcification determined by electron beam tomography and arterial stiffness index determined by a VitalVision device in asymptomatic subjects

    abstract:BACKGROUND:Arterial stiffness has recently been proposed as a powerful independent predictor of cardiovascular disease. However, the influence of arterial stiffening on the interaction between the heart and large vessels and atherosclerosis is not well defined. The arterial stiffness index (ASI) has recently been deter...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2005.06.011

    authors: Altunkan S,Oztas K,Seref B

    更新日期:2005-12-01 00:00:00

  • Vaccine-preventable diseases: from paediatric to adult targets.

    abstract::The morbidity and mortality related to many communicable infectious diseases have significantly decreased in Western countries largely because of the use of antibiotics, and the implementation of well-planned vaccination strategies and national immunisation schedules specifically aimed at infants and children. However...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2013.12.004

    authors: Esposito S,Durando P,Bosis S,Ansaldi F,Tagliabue C,Icardi G,ESCMID Vaccine Study Group (EVASG).

    更新日期:2014-03-01 00:00:00

  • Association of a DNA polymorphism of the apolipoprotein AI-CIII-AIV gene cluster with myocardial infarction in a Tunisian population.

    abstract:BACKGROUND:Apolipoproteins AI-CIII-AIV play important roles in the metabolism of triglycerides and high-density lipoprotein cholesterol. However, whether genetic variations in the ApoAI-CIII-AIV gene cluster are associated with the risk of myocardial infarction (MI) remains uncertain. In the present study, we examined ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2011.03.002

    authors: Sediri Y,Kallel A,Feki M,Mourali S,Elasmi M,Abdessalem S,Mechmeche R,Jemaa R,Kaabachi N

    更新日期:2011-08-01 00:00:00

  • Clinical indications for the albumin use: still a controversial issue.

    abstract::Human serum albumin (HSA) is the most abundant circulating protein and accounts for about 70% of the plasma colloid osmotic pressure. Beside the well known capacity to act as plasma-expander, HSA is provided of many other properties which are unrelated to the regulation of fluid compartmentalization, including binding...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2013.05.015

    authors: Caraceni P,Domenicali M,Tovoli A,Napoli L,Ricci CS,Tufoni M,Bernardi M

    更新日期:2013-12-01 00:00:00

  • Myelodysplastic syndromes and acute myeloid leukemias in the elderly.

    abstract::Most patients above 60 years with acute myeloid leukemia (AML) will die from their disease. Nevertheless, the treatment concepts in elderly patients with myelodysplastic syndromes (MDS) and AML are rapidly evolving. A number of recent reports have identified better survival rates with intensive induction chemotherapy ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2018.05.026

    authors: Mueller BU,Seipel K,Pabst T

    更新日期:2018-12-01 00:00:00

  • β-Thalassemia heterozygote state detrimentally affects health expectation.

    abstract:BACKGROUND:Thalassemia minor (Tm) individuals, are generally considered healthy. However, the prognosis of Tm individuals has not been extensively studied. The aim of this study was to evaluate the prognosis of Tm versus controls without β-thalassemia carrier state. METHODS:A total of 26,006 individuals seeking thalas...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2018.06.009

    authors: Graffeo L,Vitrano A,Scondotto S,Dardanoni G,Pollina Addario WS,Giambona A,Sacco M,Di Maggio R,Renda D,Taormina F,Triveri A,Attanasio M,Gluud C,Maggio A

    更新日期:2018-08-01 00:00:00

  • Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013.

    abstract:BACKGROUND:To describe trends in the rates and short-term outcomes of renal transplants (RTx) among patients with or without diabetes in Spain (2002-2013). METHODS:We used national hospital discharge data to select all hospital admissions for RTx. We divided the study period into four three-year periods. Rates were ca...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2016.07.031

    authors: López-de-Andrés A,de Miguel-Yanes JM,Hernández-Barrera V,Méndez-Bailón M,González-Pascual M,de Miguel-Díez J,Salinero-Fort MA,Pérez-Farinós N,Jiménez-Trujillo I,Jiménez-García R

    更新日期:2017-01-01 00:00:00

  • Chronic disseminated intravascular coagulation caused by an aorto-bifemoral aneurysm.

    abstract::This article reports the case of a patient with chronic disseminated intravascular coagulation that led to the diagnosis of an otherwise asymptomatic aorto-bifemoral aneurysm. The bleeding disorder completely resolved with the surgical resection of the aneurysm. Fibrinogen replacement therapy prior to invasive diagnos...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2004.11.012

    authors: Jimeno A,Toledo T,Moya I,González-Barber A

    更新日期:2005-08-01 00:00:00

  • Serious infections due to methicillin-resistant Staphylococcus aureus: an evolving challenge for physicians.

    abstract::Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized major cause of nosocomial infection worldwide. During the past decade, however, the epidemiology of staphylococcal infections has partially changed, with an increase in the number of patients who acquire infections in the community. The changing e...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2008.08.016

    authors: Falcone M,Serra P,Venditti M

    更新日期:2009-07-01 00:00:00

  • Association between venous and arterial thrombosis: clinical implications.

    abstract::Venous and arterial thromboses have traditionally been regarded as separate diseases with different causes. However, recent epidemiological studies have documented an association between these vascular complications, probably due to the presence of more overlapping risk factors than previously recognized. This narrati...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ejim.2012.02.008

    authors: Franchini M,Mannucci PM

    更新日期:2012-06-01 00:00:00

  • Comparison of demographic and clinical characteristics of patients with early vs. adult vs. late onset ulcerative colitis.

    abstract:BACKGROUND & AIMS:There is limited data comparing influence of age on the presentation, clinical course, and therapeutic response of patients with ulcerative colitis. We aimed to compare the demographic and clinical characteristics of patients diagnosed with UC in older age vs. adulthood vs. early age. METHODS:Five-hu...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2012.12.014

    authors: Kalkan IH,Dağli U,Oztaş E,Tunç B,Ulker A

    更新日期:2013-04-01 00:00:00

  • Anticholinergic drug exposure at intensive care unit admission affects the occurrence of delirium. A prospective cohort study.

    abstract:BACKGROUND:Anticholinergic drugs may increase the risk of delirium in non-critically ill patients, but it is unclear whether exposure to these drugs is also a risk factor for Intensive Care Unit (ICU) delirium. In this study the hypothesis was tested that anticholinergic drug exposure at ICU admission increases the ris...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2020.04.062

    authors: Vondeling AM,Knol W,Egberts TCG,Slooter AJC

    更新日期:2020-08-01 00:00:00

  • A comparative analysis of novel cardiovascular biomarkers in patients with chronic heart failure.

    abstract:BACKGROUND:Heart failure (HF) with reduced ejection fraction remains a major therapeutic challenge. The aim of this study was to investigate the role of novel cardiovascular biomarkers, i.e. soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator ...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2017.05.027

    authors: Lichtenauer M,Jirak P,Wernly B,Paar V,Rohm I,Jung C,Schernthaner C,Kraus J,Motloch LJ,Yilmaz A,Hoppe UC,Christian Schulze P,Kretzschmar D,Pistulli R

    更新日期:2017-10-01 00:00:00

  • Abnormal ankle-brachial index (ABI) predicts primary and secondary cardiovascular risk and cancer mortality.

    abstract:BACKGROUND:An abnormal ankle-brachial pressure index (ABI) is a marker of the risk for increased total and cardiovascular (CV) mortality. However, it is not clear whether it is associated with an even worse prognosis in patients with previous CV events or with cancer mortality. MATERIALS AND METHODS:Consecutive subjec...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2020.02.033

    authors: Visonà A,De Paoli A,Fedeli U,Tonello D,Zalunardo B,Zanatta N,Martini R,Pesavento R,Cuppini S,Prior M,Benazzi S,Cimminiello C,Avossa F

    更新日期:2020-07-01 00:00:00

  • Heritability of the femoral intima media thickness.

    abstract:BACKGROUND:The measurement of femoral intima-media thickness (IMT) is underutilized in the clinical practice, although it is a surrogate marker of cardiovascular disease. MATERIALS AND METHODS:388 Hungarian and Italian twins (121 monozygotic, 73 dizygotic pairs) underwent bilateral B-mode sonography of femoral arterie...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.ejim.2017.02.019

    authors: Fejer B,Tarnoki AD,Tarnoki DL,Lucatelli P,Littvay L,Maurovich-Horvat P,Jermendy AL,Kovacs A,Godor E,Fagnani C,Stazi MA,Molnar AA,Fanelli F,Cirelli C,Farina F,Baracchini C,Meneghetti G,Pucci G,Jermendy G,Merkely B,

    更新日期:2017-06-01 00:00:00

  • Effect of weight reduction on serum ghrelin and TNFalpha concentrations in obese women.

    abstract::Background: Ghrelin causes weight gain by increasing food intake in rodents. Tumor necrosis factor alpha (TNFalpha) is produced by adipose tissue, modulates its metabolism and stimulates catabolic processes. The aim of our study was to evaluate whether weight loss treatment modulates serum concentrations of TNFalpha a...

    journal_title:European journal of internal medicine

    pub_type: 杂志文章

    doi:10.1016/j.ejim.2004.02.002

    authors: Zahorska-Markiewicz B,Mizia-Stec K,Olszanecka-Glinianowicz M,Janowska J

    更新日期:2004-06-01 00:00:00