Impediments to deprescription in Brazil: overview from a panel of geriatrics experts

• Autor(a) principal: Teixeira,Juliana Junqueira Marques
• Data de Publicação: 2022
• Outros Autores: Provin,Mercia Pandolfo, Freitas,Marco Polo Dias, Santana,Fabiana Ribeiro, Pedatella,Marco Tulio Araujo, Rocha,Luis Eduardo de Araujo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/1733
• topic: deprescription, older adults, medication use, health care, consensus.

<p><b>OBJECTIVES:</b>To identify impediments to deprescription among older adults from the perspectiveof a panel of Brazilian geriatricians.<br> <b>METHODS:</b> The Delphi method was used to obtain a consensus among Brazilian geriatricians about the factors that influence the lack of deprescription for older adults in clinical practice.The study was developed in two stages: (i) a survey and description of potential factorsinvolved in deprescription; and (ii) applying the results of the survey to a panel of experts to obtain a consensus.<br> <b>RESULTS:</b> The deprescription process is influenced by the interaction of three pillars of older adulthealth care: the prescriber, the patient-family, and the health care system. In the professional and health care systems, professional training and communication skills, prolonged clinicalfollow-up, access to the multidisciplinary team, medical consultations of an adequate time,and unified electronic health records were identified as facilitators of deprescription. In the patient-family pillar, clear facilitators included health literacy, no sensory or cognitive deficits,and a clinical situation of transitional or palliative care.<br> <b>CONCLUSIONS:</b> Deprescription is a complex, multifactorial process that requires attention, time,and specific skills and competencies from the attending physician, but it also requires shared decision-making and a health system compatible with a culture of deprescription.</p>