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Psychotropic medications and proton-pump inhibitors were the classes most resistant to deprescribing, despite intense intervention.ĭeprescription may be successful and effective in select classes of drugs, with collaboration of clinical pharmacists for patient and provider education, and patient-specific drug recommendations, complemented by close clinical follow-up to detect early signs of exacerbation of chronic diseases. Cardiovascular drugs including antihypertensives/diuretics and nitrates were the most successfully deprescribed class of drugs. The most successful interventions used pharmacist-led educational interventions and patient-specific drug recommendations.
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Studies varied in duration from 4 weeks to 5 years and were conducted across a diverse array of primary health care settings. Thirty-three (58%) had a high risk of bias. Primary outcome was successful deprescription, defined as a statistically significant reduction in medication burden between the intervention group and the standard care or control group, or when more than 50% of intervention subjects were able to tolerate medication discontinuation compared with control by the end of the study.įifty-eight articles met the study criteria.
#Q dir review portable
Q-Dir is available in portable and installed versions. It makes the file management process easy. It features color coded file filters, various layouts and columns a user can customize, quick access to favorites folder, command line, and more. Subjects were non-terminally ill adults 18 years and older. Q-Dir is light, convenient and customizable. This review included outpatient, assisted living, nursing home, and acute care settings (if medications for chronic disease were deprescribed). Each study was assessed for bias with the Cochrane Collaboration tool. The databases searched include PubMed, Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science. The focus was on chronic medical and mental health conditions managed in primary care. Perform a systematic review to evaluate the outcome of deprescription compared with standard care.