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Editorial| Volume 19, ISSUE 11, P919-922, November 2018

Deprescribing in Geriatric Medicine: Challenges and Opportunities

  • Philip D. Sloane
    Correspondence
    Address correspondence to Philip D. Sloane, MD, MPH, Center for Health Services Research and Departments of Family Medicine and Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.
    Affiliations
    Cecil G. Sheps Center for Health Services Research and Departments of Family Medicine and Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
    Search for articles by this author
  • Sheryl Zimmerman
    Affiliations
    Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
    Search for articles by this author
      Drug safety, polypharmacy, and deprescribing are important issues in post-acute and long-term care medicine and therefore also of great interest to JAMDA's editors and readers. This issue of JAMDA features a number of articles that advance the discussion of these topics. Two articles document and describe prescribing behavior—one on the challenges clinicians face determining whether and, if so, when antipsychotics are appropriate to prescribe
      • Walsh K.A.
      • Sinnott C.
      • Fleming A.
      • et al.
      Exploring antipsychotic prescribing behaviors for nursing home residents with dementia: A qualitative study.
      ; the other on the subjective nature of opioid prescribing decisions.
      • Martens M.
      • Janssen D.
      • Schols J.
      • an den Beuken-van Everdingen M.
      Opioid prescribing behavior in long-term geriatric care in The Netherlands.
      Several other articles shed new light on the safety and adverse effects of medications.
      • Rodriguez-Pascual I.
      • Torres-Torres I.
      • Gomez-Quintanilla A.
      • et al.
      Safety of direct oral anticoagulants and vitamin K antagonists in oldest old patients: A prospective study.
      • Lattanzio F.
      • Onder G.
      • La Fauci M.
      • et al.
      Anticholinergic burden is associated with increased mortality in older patients with dependency discharged from hospital.
      • Martinot P.
      • Landré B.
      • Ankri J.
      • et al.
      Association between potentially inappropriate medications and frailty in the early old age: A longitudinal study in the GAZEL cohort.
      Also included are an article on discontinuation of antipsychotic medications for persons with dementia
      • Van Leeuwen E.
      • Petrovic M.
      • Van Driel M.
      • et al.
      Discontinuation of long-term antipsychotic drug use for behavioral and psychological symptoms in older adults aged 65 and over with dementia.
      and a review of randomized controlled trials on deprescribing.
      • Dills H.
      • Shah K.
      • Messinger-Rapport B.
      • et al.
      Deprescribing medications for chronic disease management in primary care settings: A systematic review of randomized controlled trials.
      In this editorial, we address the broader context of pharmaceuticals in geriatric medicine and the challenges inherent in simplifying and reducing medication lists in older patients with multiple chronic conditions.
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