Deprescribing aan het einde van het leven
Een onderzoek bij volwassenen met een verminderde levensverwachting
Summary
Deprescribing of medications at the end of life
Kristel Paque
AIM: To examine how many (potentially inappropriate or unnecessary) medications were used at the end of life, which medications were involved, and to what extent medications considered suitable for deprescribing were actually deprescribed in the last year of life.
METHOD: Quantitative analyses of existing databases including data of nursing home residents, all deceased aged 75 years and older in Belgium in 2012 (population study), and advanced cancer patients. Systematic review on barriers/enablers to deprescribing of medications in people with life-limiting diseases.
FINDINGS: The number of people for whom medications considered suitable for deprescribing were actually deprescribed, was limited to 20% in the population study, and to 31% in nursing home residents. We distinguished three types of factors that can hinder and/or facilitate deprescribing of medications: factors related to the (1) organization, (2) healthcare professionals, and (3) patient and family.
CONCLUSION: Medications are seldom reconsidered in the last year of life. Judicious deprescribing of medications is very limited in this situation. Improving interdisciplinary communication, participation and collaboration in e.g. medication review is key to successful deprescribing interventions.
Keywords:Deprescriptions, palliative care, pharmacotherapy