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Journal of the American Geriatrics Society. 2024 Mar;72(3):660-669. doi: 10.1111/jgs.18667 Q14.52025

Deprescribing medications among patients with multiple prescribers: A socioecological model

针对多位处方医师的患者减药策略:一个社会生态模型 翻译改进

Armando Silva Almodóvar  1, Michelle S Keller  2, Jiha Lee  3, Hemalkumar B Mehta  4, Veena Manja  5  6, Thanh Phuong Pham Nguyen  7, Juliessa M Pavon  8, Samuel W Terman  9, Daniel Hoyle  10, Amanda S Mixon  11, Amy M Linsky  12  13  14

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作者单位

  • 1 Institute of Therapeutic Innovations and Outcomes (ITIO), The Ohio State University College of Pharmacy, Columbus, Ohio, USA.
  • 2 Division of General Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • 3 Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • 4 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
  • 5 Veterans Affairs Northern California Healthcare System, Mather, California, USA.
  • 6 University of California Davis, Sacramento, California, USA.
  • 7 Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
  • 8 Division of Geriatrics, Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
  • 9 Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
  • 10 School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia.
  • 11 Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • 12 General Internal Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
  • 13 Center for Healthcare Organization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
  • 14 General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
  • DOI: 10.1111/jgs.18667 PMID: 37943070

    摘要 Ai翻译

    Deprescribing is the intentional dose reduction or discontinuation of a medication. The development of deprescribing interventions should take into consideration important organizational, interprofessional, and patient-specific barriers that can be further complicated by the presence of multiple prescribers involved in a patient's care. Patients who receive care from an increasing number of prescribers may experience disruptions in the timely transfer of relevant healthcare information, increasing the risk of exposure to drug-drug interactions and other medication-related problems. Furthermore, the fragmentation of healthcare information across health systems can contribute to the refilling of discontinued medications, reducing the effectiveness of deprescribing interventions. Thus, deprescribing interventions must carefully consider the unique characteristics of patients and their prescribers to ensure interventions are successfully implemented. In this special article, an international working group of physicians, pharmacists, nurses, epidemiologists, and researchers from the United States Deprescribing Research Network (USDeN) developed a socioecological model to understand how multiple prescribers may influence the implementation of a deprescribing intervention at the individual, interpersonal, organizational, and societal level. This manuscript also includes a description of the concept of multiple prescribers and outlines a research agenda for future investigations to consider. The information contained in this manuscript should be used as a framework for future deprescribing interventions to carefully consider how multiple prescribers can influence the successful implementation of the service and ensure the intervention is as effective as possible.

    Keywords: continuity of care; deprescribing; medication-related problems; multiple chronic conditions; multiple prescribers; polypharmacy.

    Keywords:medications deprescribing; multiple prescribers; socioecological model

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    期刊名:Journal of the american geriatrics society

    缩写:J AM GERIATR SOC

    ISSN:0002-8614

    e-ISSN:1532-5415

    IF/分区:4.5/Q1

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    Deprescribing medications among patients with multiple prescribers: A socioecological model