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减药:研究的未来方向。

Deprescribing: Future directions for research.

机构信息

Research Unit of General Practice, Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000C, Odense, Denmark.

NHMRC Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia; Geriatric Medicine Research, Faculty of Medicine and College of Pharmacy, Dalhousie University and Nova Scotia Health Authority, NS, Canada.

出版信息

Res Social Adm Pharm. 2019 Jun;15(6):801-805. doi: 10.1016/j.sapharm.2018.08.013. Epub 2018 Sep 18.

Abstract

A World Café workshop was held at the Bruyère Evidence-Based Deprescribing Guidelines Symposium in March 2018 with 30 participants (researchers, clinicians, policy makers, stakeholders). This workshop explored priorities for future work in the field of deprescribing and deprescribing guidelines through group discussion. The discussions were guided by the following questions: (1) What are deprescribing research priorities (to inform guideline development), (2) What outcome measures are important for developing deprescribing guidelines, and (3) How do we evaluate the implementation and effectiveness of deprescribing guidelines? Discussion from all 3 questions identified 6 main priority areas: (1) conducting high-quality and long-term clinical trials that measure patient-important outcomes, (2) focusing on patient involvement and perspectives, (3) investigating the pharmacoeconomics of deprescribing interventions, (4) understanding deprescribing interventions in different populations, (5) generating evidence on clinical management during deprescribing (e.g. managing adverse drug withdrawal effects, subsequent re-prescribing), and (6) implementing interventions in clinical practice. These topics represent what a group of experienced researchers, clinicians, and stakeholders in the field collectively felt was important to consider for design and implementation of future deprescribing studies. The aim is for these findings to stimulate future discussions and be considered by granting agencies, policy makers, deprescribing research networks, and individual researchers planning future deprescribing studies.

摘要

2018 年 3 月,在布鲁耶尔基于证据的停药指南研讨会上举办了一次世界咖啡研讨会,共有 30 名参与者(研究人员、临床医生、政策制定者、利益相关者)参加。通过小组讨论,该研讨会探讨了停药领域和停药指南的未来工作重点。讨论以以下问题为指导:(1)停药研究的优先事项(为指南制定提供信息);(2)开发停药指南的重要结果测量指标;(3)我们如何评估停药指南的实施和效果?来自所有 3 个问题的讨论确定了 6 个主要优先领域:(1)开展高质量和长期临床试验,衡量对患者重要的结果;(2)关注患者的参与和观点;(3)研究停药干预的药物经济学;(4)了解不同人群中的停药干预措施;(5)在停药期间提供关于临床管理的证据(例如,管理药物戒断副作用,随后重新开处方);(6)在临床实践中实施干预措施。这些主题代表了一组经验丰富的研究人员、临床医生和利益相关者在设计和实施未来的停药研究时认为重要的考虑因素。目的是为了激发未来的讨论,并由资助机构、政策制定者、停药研究网络和计划未来停药研究的个别研究人员考虑这些发现。

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