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  • 1
    Article
    Article
    Language: English
    In: Expert Review of Vaccines, August, 2012, Vol.11(8), p.885(3)
    Keywords: Vaccination -- Research ; Smoking -- Psychological Aspects ; Addiction -- Risk Factors ; Addiction -- Prevention
    ISSN: 1476-0584
    E-ISSN: 17448395
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  • 2
    In: Journal of the American Geriatrics Society, September 2013, Vol.61(9), pp.1508-1514
    Description: Byline: Emily Reeve, Michael D. Wiese, Ivanka Hendrix, Michael S. Roberts, Sepehr Shakib Keywords: elderly; polypharmacy; deprescribing; potentially inappropriate medications; discontinuation Objectives To capture people's attitudes, beliefs, and experiences regarding the number of medications they are taking and their feelings about stopping medications. Design Administration of a validated questionnaire. Setting Multidisciplinary ambulatory consulting service at the Royal Adelaide Hospital. Participants Participants were individuals aged 18 and older (median 71.5) taking at least one regular prescription medication; 100 participants completed all items of the questionnaire, 65 of whom were aged 65 and older. Measurements Participants were administered the 15-item Patients' Attitudes Towards Deprescribing (PATD) questionnaire. Results Participants were taking an average of 10 different prescription and nonprescription (including complementary), regular and as-needed medications. More than 60% felt that they were taking a "large number" of medications, and 92% stated that they would be willing to stop one or more of their current medications if possible. Number of regular medications, age, and number of medical conditions were not found to be correlated with willingness to stop a medication. The findings were similar in older and younger participants. Conclusion This study has shown that a cohort of mostly older adults were largely accepting of a trial of cessation of medication(s) that their prescriber deemed to be no longer required. Because few factors were associated with willingness to cease medications, all patients should be individually evaluated for deprescribing. CAPTION(S): Figure S1. Distribution of propensity score for Intervention and Control participants. Table S1. List of Exclusionary Comorbidities, ICD-9 Codes, and CPT Codes. Table S2. Control county selection criteria. Table S3. ICD-9-CM diagnosis codes for disease classification of participants. Table S4. Regression specifications. Table S1. Comparison of frailty components for Men in the Cardiovascular Health Study (CHS) and Men in the Osteoporotic Fractures in Men (MrOS) Study.
Table S2. Association between Cystatin C and frailty status among 1,257 Subjects with eGFRCr 〉60 ml/min/1.73 m2. Table S1. Adjusted* odds ratios (95% CI) from logistic regression analyses for cognitive impairment (lowest 10% performance within ethnic group) on individual cognitive tests per 10 mmHg increment in each listed blood pressure measurement.
    Keywords: Elderly ; Polypharmacy ; Deprescribing ; Potentially Inappropriate Medications ; Discontinuation
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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  • 3
    Language: English
    In: International Journal of Clinical Pharmacy, 2014, Vol.36(1), pp.26-29
    Description: Deprescribing is a holistic process of medication cessation that encompasses gaining a comprehensive medication list, identifying potentially inappropriate medications, deciding if the identified medication can be ceased, planning the withdrawal regimen and monitoring, support and follow-up. It is currently being investigated as a mechanism to reduce unnecessary or redundant medications. However, given the systematic and patient-centred nature of the deprescribing process, it is possible that it may also confer additional benefits such as improving adherence to medications, even if there is no net reduction in overall medication use. Specifically, deprescribing may improve adherence via reducing polypharmacy, reducing the financial costs associated with medication taking, increasing the patient’s medication knowledge through education, increasing patient engagement in medication management and resolution of adverse drug reactions. More research into deprescribing must be conducted to establish if these potential benefits can be realised, in addition to establishing any negative consequences.
    Keywords: Adherence ; Deprescribing ; Inappropriate medication use ; Medication withdrawal
    ISSN: 2210-7703
    E-ISSN: 2210-7711
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  • 4
    In: International Journal of Pharmacy Practice, February 2015, Vol.23(1), pp.90-91
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/ijpp.12111/abstract Byline: Emily Reeve, Justin P. Turner ***** No abstract is available for this article. *****
    Keywords: Withholding Treatment;
    ISSN: 0961-7671
    E-ISSN: 2042-7174
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  • 5
    Language: English
    In: Journal of Bioethical Inquiry, 2016, Vol.13(4), pp.581-590
    Description: Deprescribing is the term used to describe the process of withdrawal of an inappropriate medication supervised by a clinician. This article presents a discussion of how the Four Principles of biomedical ethics (beneficence, non-maleficence, autonomy, and justice) that may guide medical practitioners’ prescribing practices apply to deprescribing medications in older adults. The view of deprescribing as an act creates stronger moral duties than if viewed as an omission. This may explain the fear of negative outcomes which has been reported by prescribers as a barrier to deprescribing. Respecting the autonomy of older adults is complex as they may not wish to be active in the decision-making process; they may also have reduced cognitive function and family members may therefore have to step in as surrogate decision-makers. Informed consent is intended as a process of information giving and reflection, where consent can be withdrawn at any time. However, people are rarely updated on the altered risks and benefits of their long-term medications as they age. Cessation of inappropriate medication use has a large financial benefit to the individual and the community. However, the principle of justice also dictates equal rights to treatment regardless of age.
    Keywords: Principlism ; Deprescribing ; Bioethics ; Medication withdrawal ; Inappropriate medication use ; Elderly
    ISSN: 1176-7529
    E-ISSN: 1872-4353
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  • 6
    Language: English
    In: British Journal of Cardiac Nursing, 12/02/2016, Vol.11(12), pp.581-585
    Description: Cardiac rehabilitation is a cost-effective, life-enhancing and lifesaving treatment for patients recovering from cardiac illness. However, certain patient groups are not attending these programmes, including women. While the National Service Framework set a target that 85% of eligible patients should be invited to join cardiac rehabilitation programmes, this target is far from being met - only 30% of eligible women are being invited, while attendance among men is 52%. Progress has been made in the diagnosis of myocardial infarction in women; the use of the high-sensitivity troponin I assay with gender-specific diagnostic thresholds increased the diagnosis rate in suspected cases from 11% to 22%. Despite this, women are less likely to join a cardiac rehabilitation programme than men, who are nearly twice as likely to attend. Women who are older, as well as those with greater comorbidity, higher levels of depression, lower initial exercise capacity, and less social support tended to be less likely to attend. A dislike of the exercise programme, and family obligations, can also reduce attendance. Practitioner endorsement of cardiac rehabilitation alongside advances in technology help to overcome some common barriers to women attending. More creative and dynamic ways need to be found to overcome these constraints to ensure that all those who are likely to benefit from these programmes do so. References
    Keywords: Heart Disorders : Rehabilitation ; Women'S Health ; Health Provision ; Gender Issues ; Gender ; Health Care Access ; Cardiovascular Disease ; Rehabilitation ; Womens Health ; United Kingdom–UK;
    ISSN: 1749-6403
    E-ISSN: 2052-2207
    Source: CrossRef
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  • 7
    Language: English
    In: British Journal of Cardiac Nursing, 03/02/2016, Vol.11(3), pp.111-111
    Description: Interview with the British Heart Foundation's senior cardiac nurse about smoking cessation, the role of cardiac nurses in providing support and No Smoking Day 2016.
    Keywords: Smoking ; Heart Disorders : Nursing ; Voluntary Organisations ; Cardiovascular Disease ; Nurse Specialists ; Charities ; United Kingdom–UK;
    ISSN: 1749-6403
    E-ISSN: 2052-2207
    Source: CrossRef
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  • 8
    Language: English
    In: Journal of Renal Nursing, 03/02/2016, Vol.8(2), pp.57-57
    Keywords: Editorial;
    ISSN: 2041-1448
    E-ISSN: 2052-2894
    Source: CrossRef
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  • 9
    Language: English
    In: Expert review of vaccines, September 2012, Vol.11(9), pp.1035
    Keywords: Antibodies -- Immunology ; Neutrophils -- Immunology ; Vaccines -- Immunology
    ISSN: 14760584
    E-ISSN: 1744-8395
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  • 10
    Language: English
    In: International journal of clinical pharmacy, February 2013, Vol.35(1), pp.51-6
    Description: There is a large amount of research into and promotion of rational prescribing, but there is a comparative lack of investigation into deprescribing. The success of deprescribing is likely to be dependent on both medical and patient factors. The aim of this study was to develop and validate a tool to capture the views and beliefs of patients regarding cessation of medications. Setting Participants were recruited from a multidisciplinary clinic at the Royal Adelaide Hospital and Hampstead Rehabilitation Centre. The patients' attitudes towards deprescribing (PATD) questionnaire was developed through expert opinion and piloting. Psychometric testing included face, content and criterion validity, sensitivity and test-retest reliability. A final 15 item questionnaire was produced. Through piloting, expert review and gamma rank correlation with the previously validated beliefs about medicines questionnaire, the PATD was determined to be valid. Test-retesting resulted in a total concordance of 71.3 % (95 % confidence interval, 64.1-78.5 %). The PATD has acceptable psychometric properties and has potential for future use in research and practice to not only determine patients' willingness towards deprescribing, but also uncover what beliefs may influence this.
    Keywords: Attitude ; Polypharmacy ; Surveys and Questionnaires
    ISSN: 22107703
    E-ISSN: 2210-7711
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