Pharmacy Service, Universitary Hospital Virgen del Rocio, Sevilla, Spain.
Andalusian Agency for Health Technology Assessment (AETSA), Seville, Spain.
Geriatr Gerontol Int. 2017 Nov;17(11):2200-2207. doi: 10.1111/ggi.13062. Epub 2017 May 21.
To create a tool to identify drugs and clinical situations that offers an opportunity of deprescribing in patients with multimorbidity.
A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the literature and brainstorming as possible situations for deprescribing. They were also asked to assess the influence of life prognosis in each criterion. A tool was composed of the most appropriate criteria according to the strength of their evidence, usefulness in patients with multimorbidity and applicability in clinical practice.
Out of a total of 100, 27 criteria were selected to be included in the final list. It was named the LESS-CHRON criteria (List of Evidence-baSed depreScribing for CHRONic patients), and was organized by the anatomical group of the Anatomical, Therapeutic, Chemical (ATC) classification system of the drug to be deprescribed. Each criterion contains: drug indication for which it is prescribed, clinical situation that offers an opportunity to deprescribe, clinical variable to be monitored and the minimum time to follow up the patient after deprescribing.
The "LESS-CHRON criteria" are the result of a comprehensive and standardized methodology to identify clinical situations for deprescribing drugs in chronic patients with multimorbidity. Geriatr Gerontol Int 2017; 17: 2200-2207.
创建一种工具，以识别药物和临床情况，为患有多种疾病的患者提供减药机会。
采用文献综述与电子头脑风暴相结合的方法，并随后应用专家小组德尔菲法。专家们评估了文献和头脑风暴中确定的标准，这些标准可能是减药的情况。他们还被要求评估每个标准对预后的影响。根据证据强度、对多种疾病患者的有用性和在临床实践中的适用性，选择最合适的标准组成一个工具。
从总共 100 个标准中，选择了 27 个标准列入最终清单。它被命名为 LESS-CHRON 标准（用于慢性患者的基于证据的减药清单），并按药物的解剖治疗化学（ATC）分类系统的解剖组组织。每个标准包含：规定的药物适应证、提供减药机会的临床情况、要监测的临床变量以及减药后随访患者的最短时间。
“LESS-CHRON 标准”是一种全面、标准化的方法，用于识别患有多种慢性疾病的患者减药的临床情况。老年医学杂志 2017；17: 2200-2207。
