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
1; the other on the subjective nature of opioid prescribing decisions.
- Walsh K.A.
- Sinnott C.
- Fleming A.
- et al.
Exploring antipsychotic prescribing behaviors for nursing home residents with dementia: A qualitative study.
J Am Med Dir Assoc. 2018; 19: 948-958
2Several other articles shed new light on the safety and adverse effects of medications.
- Martens M.
- Janssen D.
- Schols J.
- an den Beuken-van Everdingen M.
Opioid prescribing behavior in long-term geriatric care in The Netherlands.
J Am Med Dir Assoc. 2018; 19: 974-980
- 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.
J Am Med Dir Assoc. 2018; 19: 936-941
- Lattanzio F.
- Onder G.
- La Fauci M.
- et al.
Anticholinergic burden is associated with increased mortality in older patients with dependency discharged from hospital.
J Am Med Dir Assoc. 2018; 19: 942-947
5Also included are an article on discontinuation of antipsychotic medications for persons with dementia
- 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.
J Am Med Dir Assoc. 2018; 19: 967-973
6and a review of randomized controlled trials on deprescribing.
- 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.
J Am Med Dir Assoc. 2018; 19: 1009-1014
7In 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.
- 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.
J Am Med Dir Assoc. 2018; 19: 923-935
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- Exploring antipsychotic prescribing behaviors for nursing home residents with dementia: A qualitative study.J Am Med Dir Assoc. 2018; 19: 948-958
- Opioid prescribing behavior in long-term geriatric care in The Netherlands.J Am Med Dir Assoc. 2018; 19: 974-980
- Safety of direct oral anticoagulants and vitamin K antagonists in oldest old patients: A prospective study.J Am Med Dir Assoc. 2018; 19: 936-941
- Anticholinergic burden is associated with increased mortality in older patients with dependency discharged from hospital.J Am Med Dir Assoc. 2018; 19: 942-947
- Association between potentially inappropriate medications and frailty in the early old age: A longitudinal study in the GAZEL cohort.J Am Med Dir Assoc. 2018; 19: 967-973
- Discontinuation of long-term antipsychotic drug use for behavioral and psychological symptoms in older adults aged 65 and over with dementia.J Am Med Dir Assoc. 2018; 19: 1009-1014
- Deprescribing medications for chronic disease management in primary care settings: A systematic review of randomized controlled trials.J Am Med Dir Assoc. 2018; 19: 923-935
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The authors declare no conflicts of interest.
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.