Abstract:
:Deprescribing has gained interest recently, driven by an ageing population seeing an increasing number living with multiple long-term conditions. This, coupled with disease-specific guidelines derived from clinical trials in younger people, has led to an increase in exposure to polypharmacy and the associated therapeutic burden. Older people, especially those living with frailty, tend to experience lower efficacy of these medications along with a higher risk of drug adverse effects. Explanations for these differences include the physiological effects of frailty, drug-drug interactions, drug-disease interactions and reduced medication adherence. Adverse drug reactions often go unnoticed and can trigger further prescribing. Certain medications have been recognised as potentially inappropriate for people with frailty, yet their use remains common. Evidence suggests that many older people are open to the concept of reducing medications. Deprescribing should be based around a shared decision-making approach. Trials to date have suggested that it can often be achieved without harm. To date, there are few data to support improvements in hospitalisation or mortality rates. However, there is some evidence that it may reduce polypharmacy, improve medication adherence, reduce financial costs and improve quality of life. In the future, it will be necessary to grow the evidence base and improve public and clinician awareness of the potential benefits of deprescribing. It will require excellent team working and communication between all of those involved in the prescribing and administration of medications, also supported by improved healthcare informatics. Non-pharmacological approaches will need to be promoted. Fewer drugs is not less care.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Woodford HJ,Fisher Jdoi
10.1093/ageing/afz109subject
Has Abstractpub_date
2019-11-01 00:00:00pages
768-775issue
6eissn
0002-0729issn
1468-2834pii
5583946journal_volume
48pub_type
杂志文章相关文献
AGE AND AGEING文献大全abstract:OBJECTIVES:to test the hypothesis as to whether persons newly discharged into the community following an acute stroke and assigned a stroke case manager would experience, compared to usual post-hospital care, better health-related quality of life (HRQL), fewer emergency room visits and less non-elective hospitalisation...
journal_title:Age and ageing
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/ageing/afm133
更新日期:2008-01-01 00:00:00
abstract::This paper describes how a sample of elderly people were identified from the electoral register using an initial postal screen, and reports a technique that was used to increase the response to the screen. ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/16.2.119
更新日期:1987-03-01 00:00:00
abstract:INTRODUCTION:a professional man sustained a residual, persisting, isolated impairment of short-term memory secondary to severe carbon monoxide poisoning. Informal, open trial of the cholinesterase inhibitor donepezil resulted in uncertain benefit. PROTOCOL:an N-of-1 randomized, double-blind controlled trial of donepez...
journal_title:Age and ageing
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ageing/31.4.307
更新日期:2002-07-01 00:00:00
abstract::From an international comparison of arm anthropometric reference norms for the elderly a new diagnostic criterion for severe wasting malnutrition was derived: corrected arm muscle area at or below 16.0 cm2 for men or 16.9 cm2 for women. Of 201 consecutive hospital admissions aged 65 years and over, 10 subjects were ma...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/14.3.149
更新日期:1985-05-01 00:00:00
abstract::One hundred and seventy residents of 11 Leicester City Council homes for the elderly, with a total of 515 beds, were studied during a 30-week period from September 1988 to March 1989 to determine the use of influenza vaccine, the levels of influenza antibody, the incidence of influenza, and the protection afforded by ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/21.3.182
更新日期:1992-05-01 00:00:00
abstract::The relationship between hip fractures and aluminium in antacids and cooking pots was examined in an epidemiological study in Sydney, Australia. A population-based case-control study was conducted and 416 men and women aged 65 years and over were recruited (209 cases and 207 controls). There was a significantly (p < 0...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/23.6.468
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:high morale is defined as future-oriented optimism. Previous research suggests that a high morale independently predicts increased survival among old people, though very old people have not been specifically studied. OBJECTIVE:to investigate whether high morale is associated with increased survival among ve...
journal_title:Age and ageing
pub_type: 杂志文章,多中心研究
doi:10.1093/ageing/afv021
更新日期:2015-07-01 00:00:00
abstract::Cellular immune function declines with age and is implicated in the increased incidence of cancer, and morbidity and mortality associated with infections in elderly people. Elderly people are at risk of nutritional depletion, including of zinc, and zinc is known to influence immunity. The present study assessed zinc s...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/20.5.345
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:the relationship between proximity to death and the amount of care provided by general practitioners (GPs) is largely unknown. OBJECTIVE:to examine the influence of the proximity to death on the frequency and length of GP contacts in the oldest old. STUDY DESIGN:this population-based follow-up study includ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afs062
更新日期:2012-11-01 00:00:00
abstract::The plasma concentration of beta-thromboglobulin was estimated in elderly in-patients using a radio-immuno-assay technique. There were highly significance differences between the mean values of patients with arterial or venous thrombosis, as compared with controls. The ability of the test to detect thrombosis above th...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/8.1.13
更新日期:1979-02-01 00:00:00
abstract::The use of a teaching machine is the assessment of mental function has been described by Gredye and his colleagues. This report concerns its use in testing 56 elderly patients suffering from functional psychiatric disorders of dementia. After a diagnostic interview patients were tested on the teaching machine as well ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/4.2.110
更新日期:1975-05-01 00:00:00
abstract::Integrated care programs have been developed to enhance the quality care for older adults in primary care. These programs usually consist of a multidisciplinary approach, with personalised care based on comprehensive geriatric assessments. However, there is limited evidence for the effectiveness of these programs in f...
journal_title:Age and ageing
pub_type: 杂志文章,评审
doi:10.1093/ageing/afw081
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:to assess the validity of the Direct Assessment of Functional Status (DAFS) performance-based functional scale for the staging of dementia severity by comparing it with established clinical, functional and cognitive scales. PATIENTS AND METHODS:93 consecutive Alzheimer's disease patients underwent DAFS. Soci...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/27.5.615
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:thickened fluids are commonly advised to minimise the risk of aspiration in people with dysphagia, although many do not comply with this treatment. In health economics, utilities are values that reflect an individual's preferences for different health states. We examined the healthcare utilities, elicited us...
journal_title:Age and ageing
pub_type: 杂志文章,随机对照试验
doi:10.1093/ageing/afv194
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Obtaining well-founded estimates of the effect of demographic change on future health expenditures is a pressing issue in all developed countries. Thus far, expenditure projections have examined the effect of age on health care costs, but fail to account for the influence of remaining life expectancy on cost...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afh187
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:in some current policy discussions concerning long-term care, the emphasis has been almost solely on the costs of care. This dialogue must be replaced with a discussion of value, which emphasizes both the costs of care and quality of care. While the Resident Assessment Instrument (RAI) was originally designe...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/26.suppl_2.77
更新日期:1997-09-01 00:00:00
abstract::In Hong Kong, about 15% of older people (aged 80 and above) live in care homes, one of the highest proportions in the world. During the spread of severe acute respiratory syndrome in 2003, the crude fatality rate for older people in care homes that were infected was 72%. After taking the advice of a team of internatio...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa234
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:the study of factors associated with age-related gait decline may assist in developing methods to preserve mobility in older people. OBJECTIVE:to examine the associations between sensorimotor factors relevant to ageing and gait in the general older population. DESIGN:cross-sectional population-based study....
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afp017
更新日期:2009-05-01 00:00:00
abstract::The Rivermead ADL scale was developed for assessing activities of daily living in stroke patients but was not validated for elderly subjects. This study was designed to validate the scale for patients aged over 64 years. A series of 150 stroke patients was assessed on the scale, of whom 103 were aged over 64 years. Th...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/19.1.19
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Using Newcastle 85+ Study data, we investigated transitions between frailty states from age 85 to 90 years and whether multi-morbidities and socioeconomic status (SES) modify transitions. METHODS:The Newcastle 85+ Study is a prospective, longitudinal cohort study of all people born in 1921 in Newcastle and ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afaa054
更新日期:2020-10-23 00:00:00
abstract::Faecal incontinence occurring at least once weekly was found in 10.3% of residents in 30 residential homes for the elderly. Fifty-two randomly-selected incontinent residents were prescribed treatment and the outcome was compared with 30 incontinent residents acting as controls. The vast majority of all incontinent res...
journal_title:Age and ageing
pub_type: 临床试验,杂志文章
doi:10.1093/ageing/15.1.41
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Delirium is a disorder affecting consciousness, which gives rise to core clinical features and associated symptoms. Older patients are particularly prone, owing to higher rates of pre-existing cognitive impairment, frailty, co-morbidity and polypharmacy. OBJECTIVES:The aim of this study was to investigate t...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afq052
更新日期:2010-07-01 00:00:00
abstract:Background:Pain and delirium are common in people with dementia admitted to hospitals. These are often under-diagnosed and under-treated. Pain is implicated as a cause of delirium but this association has not been investigated in this setting. Objective:To investigate the relationship between pain and delirium in peop...
journal_title:Age and ageing
pub_type: 杂志文章,多中心研究
doi:10.1093/ageing/afy112
更新日期:2018-11-01 00:00:00
abstract::This study describes a survey of 256 informal carers and elderly people they support, and examines the impact of the caring role upon quality of life. Carers reported that many aspects of their physical and mental health as well as their social and family lives were affected by their caring. For many the caring activi...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/21.6.421
更新日期:1992-11-01 00:00:00
abstract::The effect of leukoaraiosis or white matter low attenuation (WMLA) on cognitive function is not fully understood. We compared the neuropsychological performance of 37 Alzheimer's disease patients with WMLA on CT brain scans with a similar group of 31 Alzheimer's disease patients with no evidence of white matter lesion...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/25.6.443
更新日期:1996-11-01 00:00:00
abstract::The General Medical Council (GMC) provides a core curriculum for all medical degrees in the UK. However, these guidelines do not provide in-depth, specific learning outcomes for the various medical specialties. Recognising our ageing population, the British Geriatrics Society in 2013 published their own supplementary ...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afw003
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:to compare the cost effectiveness of post-acute care for older people provided in community hospitals with general hospital care. DESIGN:cost-effectiveness study embedded within a randomised controlled trial. SETTING:seven community hospitals and five general hospitals at five centres in the midlands and n...
journal_title:Age and ageing
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/ageing/afn120
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:frequent emergency department (ED) attendance at the end of life disrupts care continuity and contradicts most patients' preference for home-based care. OBJECTIVE:to examine factors associated with frequent (≥3) end of life ED attendances among older people to identify opportunities to improve care. METHOD...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afz043
更新日期:2019-09-01 00:00:00
abstract:Introduction:frailty is an increased vulnerability to adverse health outcomes, across multiple physiological systems, with both environmental and genetic drivers. The two most commonly used measures are Rockwood's frailty index (FI) and Fried's frailty phenotype (FP). Material and methods:the present study included 36...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afx122
更新日期:2018-01-01 00:00:00
abstract::This is the second in an occasional series of paired commentaries in Age and Ageing, the Journal of the British Geriatrics Society and the Journal of the American Geriatrics Society (JAGS). The aim is to address issues of current significance and to foster dialogue and increased understanding between academics and cli...
journal_title:Age and ageing
pub_type: 杂志文章
doi:10.1093/ageing/afy008
更新日期:2018-05-01 00:00:00