Description

Gradalski provides guidance for deprescribing and prescribing for a patient entering palliative care. The author is from St. Lazarus Hospice in Krakow, Poland.


Patient selection: admission to palliative care

 

Problems in medications:

(1) polypharmacy

(2) lack of necessary concomitant drug

(3) inappropriate medications

 

Patients who are more likely to be receiving inappropriate medications:

(1) bed-bound

(2) short life expectancy

(3) admitted from hospital

(4) polypharmacy

 

Common problems:

(1) therapy for primary long-term prevention

(2) therapy for which time-to-benefit is greater than life expectancy

(3) drugs with no evidence of effectiveness or with marginal benefit

(4) drug interactions

(5) failure to adjust for renal impairment

 

Admission to palliative care is an opportunity to deprescribe inappropriate drugs and to avoid adverse drug effects that may interfere with the patient's final days.

 


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