Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA.
Department of Gerontology, McCormack Graduate School of Policy and Global Studies, UMass Boston, Boston, MA, USA.
Expert Rev Clin Pharmacol. 2023 May;16(5):411-421. doi: 10.1080/17512433.2023.2197592. Epub 2023 Apr 19.
Pharmacotherapy plays a critical role in the delivery of high-quality palliative care, but the intersection of palliative care and deprescribing has received little attention.
We conducted a scoping review of English language articles using PubMed to identify relevant publications between 1 January 2000 to 31 July 2022 using search terms of deprescribing, palliative care, end of life, and hospice. We summarize current definitions and developments in palliative care and deprescribing from both clinical and research perspectives. We highlight key challenges and outline proposed solutions and needed research.
The future of deprescribing in palliative care requires the development and adoption of individualized approaches to medication management, including a reconsidered approach to communication about deprescribing. Evidence from high-quality clinical outcomes studies is lacking, and the field needs new approaches to coordination of care delivery. This review article will be of interest to both clinical and research-based pharmacists, physicians, and nurses interested in improving care for patients with serious illness.
药物治疗在提供高质量的姑息治疗中起着至关重要的作用,但姑息治疗和减药的交叉点却很少受到关注。
我们使用 PubMed 对 2000 年 1 月 1 日至 2022 年 7 月 31 日期间的英文文章进行了范围界定审查,使用的搜索词为减药、姑息治疗、生命末期和临终关怀。我们从临床和研究角度总结了姑息治疗和减药的当前定义和发展。我们强调了关键挑战,并概述了拟议的解决方案和所需的研究。
姑息治疗中减药的未来需要开发和采用个体化的药物管理方法,包括重新考虑关于减药的沟通方式。缺乏高质量临床结局研究的证据,该领域需要新的方法来协调护理服务的提供。这篇综述文章将引起对改善重病患者护理感兴趣的临床和基于研究的药剂师、医生和护士的兴趣。