Impact of a Comprehensive Intervention Bundle Including the Drug Burden Index on Deprescribing Anticholinergic and Sedative Drugs in Older Acute Inpatients: A Non-randomised Controlled Before-and-After Pilot Study

Article Pharmacology & Pharmacy

A stewardship program to facilitate anticholinergic and sedative medication deprescribing using the drug burden index in electronic medical records

Nashwa Masnoon et al.

Summary: The study aims to determine the uptake and implementation of recommendations for deprescribing anticholinergic and sedative medications by the medical team, as well as the outcomes of these recommendations.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2023)

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Article Medicine, General & Internal

The MedSafer Study-Electronic Decision Support for Deprescribing in Hospitalized Older Adults A Cluster Randomized Clinical Trial

Emily G. McDonald et al.

Summary: This cluster randomized clinical trial evaluated the impact of an electronic deprescribing decision support tool on adverse drug events (ADEs) after hospital discharge among older adults with polypharmacy. The study found that while deprescribing did not have a significant effect on ADEs, it did lead to improvements in deprescribing.

JAMA INTERNAL MEDICINE (2022)

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Article Multidisciplinary Sciences

Introducing riskCommunicator: An R package to obtain interpretable effect estimates for public health

Jessica A. Grembi et al.

Summary: Traditional statistical modeling methods may not generate the most relevant or easily interpreted effect estimates for risk communication. Overreliance on odds ratios and relative effect measures can limit the potential impact of epidemiological and public health research. To address this issue, we have developed a user-friendly R package, called riskCommunicator, which facilitates the presentation of various effect measures.

PLOS ONE (2022)

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Editorial Material Medicine, General & Internal

Establishing the worth of deprescribing inappropriate medications: are we there yet?

Ian A. Scott et al.

MEDICAL JOURNAL OF AUSTRALIA (2022)

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Article Health Care Sciences & Services

Challenges of opioid deprescribing and factors to be considered in the development of opioid deprescribing guidelines: a qualitative analysis

Aili Langford et al.

Summary: This study explored healthcare professional stakeholders' perspectives on the challenges associated with opioid deprescribing and factors to be considered in developing deprescribing guidelines. It found that healthcare professionals view opioid deprescribing as a complex and challenging practice with various barriers in clinical settings. They emphasized the need for evidence-based guidance and a multi-target, multimodal intervention strategy in prospective opioid deprescribing guidelines to address patient psychosocial factors.

BMJ QUALITY & SAFETY (2021)

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Review Medicine, General & Internal

Deprescribing in the Older Patient: A Narrative Review of Challenges and Solutions

Harry Wu et al.

Summary: Deprescribing is an established strategy to reduce polypharmacy and potentially inappropriate medications in older people, but there is limited clinical evidence for its effectiveness on global and geriatric outcomes. Challenges at various levels of the healthcare system may impact the success of deprescribing interventions in research and practice, requiring comprehensive management strategies to overcome them. Future studies should consider large multicenter prospective designs to establish the effects and sustainability of deprescribing interventions on clinical outcomes.

INTERNATIONAL JOURNAL OF GENERAL MEDICINE (2021)

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Article Geriatrics & Gerontology

Iterative Development of Clinician Guides to Support Deprescribing Decisions and Communication for Older Patients in Hospital: A Novel Methodology

M. H. Duong et al.

Summary: This study demonstrates a novel approach to developing evidence-based recommendations that support deprescribing in routine hospital care. The guides present evidence-based information in a format that aligns with the workflows of multidisciplinary hospital clinicians, with unique communication support provided in the form of preferred language.

DRUGS & AGING (2021)

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Article Medical Informatics

Supporting deprescribing in hospitalised patients: formative usability testing of a computerised decision support tool

Melissa T. Baysari et al.

Summary: Despite growing evidence supporting deprescribing, the practice is not widespread in hospitals. A computerized decision support tool based on DBI was tested for usability, revealing areas for improvement such as terminology and consistency. User feedback led to modifications to enhance the tool before pilot testing in hospital settings.

BMC MEDICAL INFORMATICS AND DECISION MAKING (2021)

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Article Public, Environmental & Occupational Health

Deprescribing perceptions and practice reported by multidisciplinary hospital clinicians after, and by medical students before and after, viewing an e-learning module

Brendan Ng et al.

Summary: The study revealed that while most hospital clinicians have some awareness of polypharmacy and deprescribing, there is limited actual medication review and deprescribing practice. Junior doctors feel they have a minimal role in medication review and lack knowledge of deprescribing tools.

RESEARCH IN SOCIAL & ADMINISTRATIVE PHARMACY (2021)

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Article Pharmacology & Pharmacy

Anticholinergic burden in older adult inpatients: patterns from admission to discharge and associations with hospital outcomes

Maria Herrero-Zazo et al.

Summary: This study found that a significant proportion of older patients were prescribed anticholinergic medications upon admission, and there may be an association between anticholinergic dosage and mortality. Clinicians exhibit variations in prescribing anticholinergic medications across different specialties.

THERAPEUTIC ADVANCES IN DRUG SAFETY (2021)

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Review Public, Environmental & Occupational Health

The utility of a computerised clinical decision support system intervention in home medicines review: A mixed-methods process evaluation

Mouna Sawan et al.

Summary: The study shows that the CCDSS system G-MEDSS is useful in helping ACPs identify and assess anticholinergic and sedative medications in Home Medicines Reviews. However, there are challenges in obtaining treatment goals from HMR recipients. Further refinement of the tools and their use in combination may be needed based on mixed feedback from ACPs.

RESEARCH IN SOCIAL & ADMINISTRATIVE PHARMACY (2021)

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Review Pharmacology & Pharmacy

A systems approach to identifying the challenges of implementing deprescribing in older adults across different health care settings and countries: a narrative review

Mouna Sawan et al.

EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2020)

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Article Geriatrics & Gerontology

Decrease of Anticholinergic Drug Use in Nursing Home Residents in the United States, 2009 to 2017

Ioannis Malagaris et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2020)

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Article Geriatrics & Gerontology

Attitudes of Older Adults and Caregivers in Australia toward Deprescribing

Emily Reeve et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2019)

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Article Cell Biology

Biology of frailty: Implications for clinical pharmacology and drug therapy in frail older people

Sarah N. Hilmer et al.

MECHANISMS OF AGEING AND DEVELOPMENT (2019)

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Review Health Care Sciences & Services

Reducing Potentially Inappropriate Prescriptions for Older Patients Using Computerized Decision Support Tools: Systematic Review

Luis Monteiro et al.

JOURNAL OF MEDICAL INTERNET RESEARCH (2019)

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Article Pharmacology & Pharmacy

Prevalence and incidence of prescription opioid analgesic use in Australia

Samanta Lalic et al.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2019)

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Article Medicine, General & Internal

Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study

Natali Jokanovic et al.

BMJ OPEN (2019)

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Review Pharmacology & Pharmacy

Integration of an electronic Drug Burden Index risk assessment tool into Home Medicines Reviews: deprescribing anticholinergic and sedative medications

Lisa Kouladjian O'Donnell et al.

THERAPEUTIC ADVANCES IN DRUG SAFETY (2019)

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Review Pharmacology & Pharmacy

A systematic review of the emerging definition of 'deprescribing' with network analysis: implications for future research and clinical practice

Emily Reeve et al.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2015)

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Article Medicine, General & Internal

Anticholinergic burden in older women: not seeing the wood for the trees?

Lynne Parkinson et al.

MEDICAL JOURNAL OF AUSTRALIA (2015)

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Article Anesthesiology

The Pattern of Opioid Management by Australian General Practice Trainees

Simon Holliday et al.

PAIN MEDICINE (2015)

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Article Geriatrics & Gerontology

Methodological Challenges in Determining Longitudinal Associations Between Anticholinergic Drug Use and Incident Cognitive Decline

Mandavi Kashyap et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2014)

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Article Public, Environmental & Occupational Health

Associations of drug burden index with falls, general practitioner visits, and mortality in older people

Prasad S. Nishtala et al.

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY (2014)

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Review Geriatrics & Gerontology

Drug Burden Index in older adults: theoretical and practical issues

Lisa Kouladjian et al.

CLINICAL INTERVENTIONS IN AGING (2014)

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Article Geriatrics & Gerontology

Anticholinergic Component of the Drug Burden Index and the Anticholinergic Drug Scale as Measures of Anticholinergic Exposure in Older People in New Zealand: A Population-Level Study

Sujita W. Narayan et al.

DRUGS & AGING (2013)

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Article Medicine, General & Internal

Investigating polypharmacy and drug burden index in hospitalised older people

O. Best et al.

INTERNAL MEDICINE JOURNAL (2013)

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Article Medicine, General & Internal

Drug Burden Index associated with function in community-dwelling older people in Finland: A cross-sectional study

Danijela Gnjidic et al.

ANNALS OF MEDICINE (2012)

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Article Pharmacology & Pharmacy

High-Risk Prescribing and Incidence of Frailty Among Older Community-Dwelling Men

D. Gnjidic et al.

CLINICAL PHARMACOLOGY & THERAPEUTICS (2012)

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Article Pharmacology & Pharmacy

Drug Burden Index and Hospitalization among Community-Dwelling Older People

Eija Lönnroos et al.

DRUGS & AGING (2012)

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Article Pharmacology & Pharmacy

Drug Burden Index, Physical Function, and Adverse Outcomes in Older Hospitalized Patients

Estelle Lowry et al.

JOURNAL OF CLINICAL PHARMACOLOGY (2012)

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Article Pharmacology & Pharmacy

Effects of Drug Burden Index on Cognitive Function in Older Men

Danijela Gnjidic et al.

JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY (2012)

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Review Health Care Sciences & Services

Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

Pavel S. Roshanov et al.

IMPLEMENTATION SCIENCE (2011)

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Article Geriatrics & Gerontology

Associations Between Drug Burden Index and Falls in Older People in Residential Aged Care

Nicholas M. Wilson et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2011)

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Article Public, Environmental & Occupational Health

Estimating Model-Adjusted Risks, Risk Differences, and Risk Ratios From Complex Survey Data

Gayle S. Bieler et al.

AMERICAN JOURNAL OF EPIDEMIOLOGY (2010)

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Article Pharmacology & Pharmacy

A Pilot Randomized Clinical Trial Utilizing the Drug Burden Index to Reduce Exposure to Anticholinergic and Sedative Medications in Older People

Danijela Gnjidic et al.

ANNALS OF PHARMACOTHERAPY (2010)

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Article Geriatrics & Gerontology

Drug Burden Index and Potentially Inappropriate Medications in Community-Dwelling Older People The Impact of Home Medicines Review

Ronald L. Castelino et al.

DRUGS & AGING (2010)

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Article Medicine, General & Internal

Drug Burden Index Score and Functional Decline in Older People

Sarah N. Hilmer et al.

AMERICAN JOURNAL OF MEDICINE (2009)

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Article Pharmacology & Pharmacy

Drug Burden Index and physical function in older Australian men

Danijela Gnjidic et al.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2009)

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Article Pharmacology & Pharmacy

The Effects of Polypharmacy in Older Adults

S. N. Hilmer et al.

CLINICAL PHARMACOLOGY & THERAPEUTICS (2009)

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Article Geriatrics & Gerontology

Impact of Residential Medication Management Reviews on Drug Burden Index in Aged-Care Homes A Retrospective Analysis

Prasad S. Nishtala et al.

DRUGS & AGING (2009)

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Article Medicine, General & Internal

A drug burden index to define the functional burden of medications in older people

Sarah N. Hilmer et al.

ARCHIVES OF INTERNAL MEDICINE (2007)

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Impact of a Comprehensive Intervention Bundle Including the Drug Burden Index on Deprescribing Anticholinergic and Sedative Drugs in Older Acute Inpatients: A Non-randomised Controlled Before-and-After Pilot Study

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