Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis (original) (raw)

Abstract

BACKGROUND

Tackling problematic polypharmacy requires tailoring the use of medicines to individual needs and circumstances. This may involve stopping medicines (deprescribing) but patients and clinicians report uncertainty on how best to do this. The TAILOR medication synthesis sought to help understand how best to support deprescribing in older people living with multimorbidity and polypharmacy.

OBJECTIVES

We identified two research questions: (1) what evidence exists to support the safe, effective and acceptable stopping of medication in this patient group, and (2) how, for whom and in what contexts can safe and effective tailoring of clinical decisions related to medication use work to produce desired outcomes? We thus described three objectives: (1) to undertake a robust scoping review of the literature on stopping medicines in this group to describe what is being done, where and for what effect; (2) to undertake a realist synthesis review to construct a programme theory that describes 'best practice' and helps explain the heterogeneity of deprescribing approaches; and (3) to translate findings into resources to support tailored prescribing in clinical practice.

DATA SOURCES

Experienced information specialists conducted comprehensive searches in MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials), Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Google (Google Inc., Mountain View, CA, USA) and Google Scholar (targeted searches).

REVIEW METHODS

The scoping review followed the five steps described by the Joanna Briggs Institute methodology for conducting a scoping review. The realist review followed the methodological and publication standards for realist reviews described by the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) group. Patient and public involvement partners ensured that our analysis retained a patient-centred focus.

RESULTS

Our scoping review identified 9528 abstracts: 8847 were removed at screening and 662 were removed at full-text review. This left 20 studies (published between 2009 and 2020) that examined the effectiveness, safety and acceptability of deprescribing in adults (aged ≥ 50 years) with polypharmacy (five or more prescribed medications) and multimorbidity (two or more conditions). Our analysis revealed that deprescribing under research conditions mapped well to expert guidance on the steps needed for good clinical practice. Our findings offer evidence-informed support to clinicians regarding the safety, clinician acceptability and potential effectiveness of clinical decision-making that demonstrates a structured approach to deprescribing decisions. Our realist review identified 2602 studies with 119 included in the final analysis. The analysis outlined 34 context-mechanism-outcome configurations describing the knowledge work of tailored prescribing under eight headings related to organisational, health-care professional and patient factors, and interventions to improve deprescribing. We conclude that robust tailored deprescribing requires attention to providing an enabling infrastructure, access to data, tailored explanations and trust.

LIMITATIONS

Strict application of our definition of multimorbidity during the scoping review may have had an impact on the relevance of the review to clinical practice. The realist review was limited by the data (evidence) available.

CONCLUSIONS

Our combined reviews recognise deprescribing as a complex intervention and provide support for the safety of structured approaches to deprescribing, but also highlight the need to integrate patient-centred and contextual factors into best practice models.

FUTURE WORK

The TAILOR study has informed new funded research tackling deprescribing in sleep management, and professional education. Further research is being developed to implement tailored prescribing into routine primary care practice.

STUDY REGISTRATION

This study is registered as PROSPERO CRD42018107544 and PROSPERO CRD42018104176.

FUNDING

This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 32. See the NIHR Journals Library website for further project information.

Plain language summary

Many patients take multiple medicines, every day, on a long-term basis. Some feel overloaded by their medicines. However, both doctors and patients have told us that they feel anxious about knowing when and how to safely stop medicines. TAILOR aimed to help by providing the information that doctors and patients need to make individual (tailored) decisions about whether or not to stop (deprescribe) medicines. We had two research questions and so used a different research method to answer each. Both methods involved us first finding all the published research looking at deprescribing for older people living with long-term conditions and using five or more medicines a day. Our first (scoping) review produced a map of what we know about deprescribing: how it is done and if it is safe. We found evidence that structured deprescribing can be safe and acceptable to clinicians, but specific effects were very varied and patient views were often not reported. Our team’s patient partners continuously reminded us that medicines mean more to individuals than just a medical effect (e.g. a ‘tablet for my blood pressure’), meaning that our research needed to describe good person-centred deprescribing. Our second (realist) review focused on this by looking at if and how tailored deprescribing decisions happen. Our results showed that health-care services need to give clinicians the permission and resources they need to work with patients to develop a joint understanding of the value of medicines, to guide decisions about using/changing medicines, and so to build and maintain trust. Our findings remind us that decisions about medicines are personal. We need to remember that any changes in medicines affect not just an individual’s disease, but also their understanding of their health and health care. Our work makes recommendations on how future practice and research can be more person centred. We are now working with patients and health-care professionals to share our findings with a wide audience.

Full text of this article can be found in Bookshelf.

References

  1. Duerden M, Avery T, Payne R. Polypharmacy and Medicines Optimisation: Making it Safe and Sound. 2013. URL: www.kingsfund.org.uk/sites/files/kf/field/field\_publication\_file/polypharmacy-and-medicines-optimisation-kingsfund-nov13.pdf (accessed 16 June 2021).
  2. Krska J, Katusiime B, Corlett SA. Validation of an instrument to measure patients’ experiences of medicine use: the Living with Medicines Questionnaire. Patient Prefer Adherence 2017;11:671–9. https://doi.org/10.2147/PPA.S126647 doi: 10.2147/PPA.S126647. [DOI] [PMC free article] [PubMed]
  3. Denford S, Frost J, Dieppe P, Cooper C, Britten N. Individualisation of drug treatments for patients with long-term conditions: a review of concepts. BMJ Open 2014;4:e004172. https://doi.org/10.1136/bmjopen-2013-004172 doi: 10.1136/bmjopen-2013-004172. [DOI] [PMC free article] [PubMed]
  4. Scottish Government Polypharmacy Model of Care Group. Polypharmacy Guidance, Realistic Prescribing 3rd Edition, 2018. Edinburgh: Scottish Government; 2018. URL: www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf (accessed 16 June 2021).
  5. Scottish Government Polypharmacy Model of Care Group. Polypharmacy: Managing Medicines. URL: https://managingmeds.scot.nhs.uk/ (accessed 16 June 2021).
  6. Reeve J, Fleming J, Britten N, Byng R, Krska J, Heaton J. Identifying enablers and barriers to individually tailored (expert generalist) prescribing: a survey of healthcare professionals in the UK. BMC Fam Pract 2018;19:17. https://doi.org/10.1186/s12875-017-0705-2 doi: 10.1186/s12875-017-0705-2. [DOI] [PMC free article] [PubMed]
  7. Barnett N, Kelly O. Deprescribing: is the law on your side? Eur J Hosp Pharmacy 2017;24:21–5. https://doi.org/10.1136/ejhpharm-2016-000949 doi: 10.1136/ejhpharm-2016-000949. [DOI] [PMC free article] [PubMed]
  8. Reeve E, Gnjidic D, Long J, Hilmer S. A systematic review of the emerging definition of ‘deprescribing’ with network analysis: implications for future research and clinical practice. Br J Clin Pharmacol 2015;80:1254–68. https://doi.org/10.1111/bcp.12732 doi: 10.1111/bcp.12732. [DOI] [PMC free article] [PubMed]
  9. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Arch Intern Med 1997;157:1531–6. https://doi.org/10.1001/archinte.157.14.1531 doi: 10.1001/archinte.157.14.1531. [DOI] [PubMed]
  10. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing 2015;44:213–18. https://doi.org/10.1093/ageing/afu145 doi: 10.1093/ageing/afu145. [DOI] [PMC free article] [PubMed]
  11. National Institute for Health and Care Excellence. Benzodiazepine/Hypnotics De-prescribing. 2019. URL: www.nice.org.uk/sharedlearning/benzodiazepine-hypnotics-deprescribing (accessed 16 June 2021).
  12. Bruyère Research Institute. What is Deprescribing? URL: https://deprescribing.org/what-is-deprescribing/ (accessed 16 June 2021).
  13. Derby and Derbyshire Clinical Commissioning Group. Deprescribing: A Practical Guide. 2019. URL: www.derbyshiremedicinesmanagement.nhs.uk/assets/Clinical\_Guidelines/clinical\_guidelines\_front\_page/Deprescribing.pdf (accessed 16 June 2021).
  14. Mangin D, Bahat G, Golomb B, Mallery L, Moorhouse P, Onder G et al. International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): position statement and ten recommendations for action. Drugs Aging 2018;35:575–87. https://doi.org/10.1007/s40266-018-0554-2 doi: 10.1007/s40266-018-0554-2. [DOI] [PMC free article] [PubMed]
  15. Farrell B, Mangin D. Deprescribing is an essential part of good prescribing. Am Fam Physician 2019;99:7–9. [PubMed]
  16. Le Bosquet K, Barnett N, Minshull J. Deprescribing: practical ways to support person-centred, evidence-based deprescribing. Pharmacy 2019;7:E129. https://doi.org/10.3390/pharmacy7030129 doi: 10.3390/pharmacy7030129. [DOI] [PMC free article] [PubMed]
  17. Reeve J, Dowrick CF, Freeman GK, Gunn J, Mair F, May C, et al. Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions. JRSM Short Rep 2013;4:2042533313510155. https://doi.org/10.1177/2042533313510155 doi: 10.1177/2042533313510155. [DOI] [PMC free article] [PubMed]
  18. Barnett NL, Oboh L, Smith K. Patient-centred management of polypharmacy: a process for practice. Eur J Hosp Pharm 2016;23:113–17. https://doi.org/10.1136/ejhpharm-2015-000762 doi: 10.1136/ejhpharm-2015-000762. [DOI] [PMC free article] [PubMed]
  19. BJGP Life. Future Doctors as Knowledge Workers. URL: https://bjgplife.com/future-doctors-as-knowledge-workers/ (accessed 11 March 2022). doi: 10.3399/bjgp22X718397. [DOI] [PMC free article] [PubMed]
  20. Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. Managing patients with multimorbidity in primary care. BMJ 2015;350:h176. https://doi.org/10.1136/bmj.h176 doi: 10.1136/bmj.h176. [DOI] [PubMed]
  21. Reeve J. Avoiding harm: tackling problematic polypharmacy through strengthening expert generalist practice. Br J Clin Pharmacol 2021;87:76–83. https://doi.org/10.1111/bcp.14531 doi: 10.1111/bcp.14531. [DOI] [PubMed]
  22. National Institute for Health and Care Excellence. David Haslam: Getting the Guidance Right. 2016. URL: www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right (accessed 16 June 2021).
  23. Montori V. Clinical Evidence for the Brave New World of Multimorbidity. 2015. URL: https://blogs.bmj.com/bmj/2015/03/19/victor-montori-clinical-evidence-for-the-brave-new-world-of-multimorbidity/ (accessed 16 June 2021).
  24. Fearon D, Hughes S, Brearley SG. A philosophical critique of the UK’s National Institute for Health and Social Care Excellence guideline ‘Palliative care for adults: strong opioids for pain relief’. Br J Pain 2018;12:183–8. https://doi.org/10.1177/2049463717753021 doi: 10.1177/2049463717753021. [DOI] [PMC free article] [PubMed]
  25. Hughes LD, McMurdo M, Guthrie B. Guidelines for people not diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age Aging 2013;42:62–9. https://doi.org/10.1093/ageing/afs100 doi: 10.1093/ageing/afs100. [DOI] [PubMed]
  26. Gabbay J, le May A. Mindlines: making sense of evidence in practice. Br J Gen Pract 2016;66:402–3. https://doi.org/10.3399/bjgp16X686221 doi: 10.3399/bjgp16X686221. [DOI] [PMC free article] [PubMed]
  27. Straus SE, McAlister FA. Evidence-based medicine: a commentary on common criticisms. CMAJ 2000;163:837–41. [PMC free article] [PubMed]
  28. Reeve J. Interpretive medicine: supporting generalism in a changing primary care world. Occas Pap R Coll Gen Pract 2010;88:1–20. [PMC free article] [PubMed]
  29. Greenhalgh T, Snow R, Ryan S, Rees S, Salisbury H. Six ‘biases’ against patients and carers in evidence-based medicine. BMC Med 2015;13:200. https://doi.org/10.1186/s12916-015-0437-x doi: 10.1186/s12916-015-0437-x. [DOI] [PMC free article] [PubMed]
  30. Donner-Banzhoff N, Hertwig R. Inductive foraging: improving the diagnostic yield of primary care consultations. Eur J Gen Pract 2014;20:69–73. https://doi.org/10.3109/13814788.2013.805197 doi: 10.3109/13814788.2013.805197. [DOI] [PubMed]
  31. Halm EA, Atlas SJ, Borowsky LH, Benzer TI, Metlay JP, Chang YC, Singer DE. Understanding physician adherence with a pneumonia practice guideline: effects of patient, system, and physician factors. Arch Intern Med 2000;160:98–104. https://doi.org/10.1001/archinte.160.1.98 doi: 10.1001/archinte.160.1.98. [DOI] [PubMed]
  32. Heaton J, Britten N, Krska J, Reeve J. Person-centred medicines optimisation policy in England: an agenda for research on polypharmacy. Prim Health Care Res Dev 2017;18:24–34. https://doi.org/10.1017/S1463423616000207\. doi: 10.1017/S1463423616000207. [DOI] [PubMed]
  33. The Health Policy Partnership. The State of Play in Person-Centred Care. URL: www.healthpolicypartnership.com/example-work/person-centred-care/ (accessed 16 June 2021).
  34. University of Plymouth. Person-Centred Coordinated Care. URL: www.plymouth.ac.uk/research/primarycare/person-centred-care (accessed 16 June 2021).
  35. World Health Organization. Primary Care, Now More Than Ever. 2008. URL: www.who.int/whr/2008/chapter3/en/ (accessed 16 June 2021).
  36. Williamson DL. Health as a resource for living: advancing the conceptualisation. Crit Pub Heal 2009;19:107–22. https://doi.org/10.1080/09581590802376234 doi: 10.1080/09581590802376234. [DOI]
  37. Tinetti ME, Fried T. The end of the disease era. Am J Med 2004;116:179–85. https://doi.org/10.1016/j.amjmed.2003.09.031 doi: 10.1016/j.amjmed.2003.09.031. [DOI] [PubMed]
  38. Hunter DJ. Leading for health and wellbeing: the need for a new paradigm. J Public Health 2009;31:202–4. https://doi.org/10.1093/pubmed/fdp036 doi: 10.1093/pubmed/fdp036. [DOI] [PubMed]
  39. Rittel HWJ, Webber MM. Dilemmas in general theory of planning. Pol Sc 1973;4:155–69. https://doi.org/10.1007/BF01405730 doi: 10.1007/BF01405730. [DOI]
  40. Burns D, Hyde P, Killett A. Wicked problems or wicked people? Reconceptualising institutional abuse. Sociol Health Illn 2013;35:514–28. https://doi.org/10.1111/j.1467-9566.2012.01511.x doi: 10.1111/j.1467-9566.2012.01511.x. [DOI] [PubMed]
  41. Riviett G. Our Health Service Presents Wicked Problems. 2012. URL: www.nuffieldtrust.org.uk/news-item/our-health-service-presents-wicked-problems (accessed 16 June 2021).
  42. Pawson R, Greenhalgh J, Brennan C. Demand management for planned care: a realist synthesis. Health Serv Deliv Res 2016;4(2). https://doi.org/10.3310/hsdr04020 doi: 10.3310/hsdr04020. [DOI] [PubMed]
  43. NHS England. Medicines Optimisation. URL: www.england.nhs.uk/medicines-2/medicines-optimisation/ (accessed 16 June 2021).
  44. Tran VT, Barnes C, Montori VM, Falissard B, Ravaud P. Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions. BMC Med 2015;13:115. https://doi.org/10.1186/s12916-015-0356-x doi: 10.1186/s12916-015-0356-x. [DOI] [PMC free article] [PubMed]
  45. Gallacher K, Morrison D, Bautesh J, MacDonald S, May CR, Montori V, et al. Uncovering treatment burden as a key concept for stroke care. PLOS Med 2013. https://doi.org/10.1371/journal.pmed.1001473\. doi: 10.1371/journal.pmed.1001473. [DOI] [PMC free article] [PubMed]
  46. Demain S, Gonçalves AC, Areia C, Oliveira R, Marcos AJ, Marques A, et al. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research. PLOS One 2015;10:e0125457. https://doi.org/10.1371/journal.pone.0125457 doi: 10.1371/journal.pone.0125457. [DOI] [PMC free article] [PubMed]
  47. Reeve J, Cooper L. Rethinking how we understand individual healthcare needs for people living with long-term conditions: a qualitative study. Health Soc Care Community 2016;24:27–38. https://doi.org/10.1111/hsc.12175 doi: 10.1111/hsc.12175. [DOI] [PubMed]
  48. Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, Campbell R. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med 2005;61:133–55. https://doi.org/10.1016/j.socscimed.2004.11.063 doi: 10.1016/j.socscimed.2004.11.063. [DOI] [PubMed]
  49. Wallace E, McDowell R, Bennett K, Fahey T, Smith SM. Impact of potentially inappropriate prescribing on adverse drug events, health related quality of life and emergency hospital attendance in older people attending general practice: a prospective cohort study. J Gerontol A Biol Sci Med Sci 2017;72:271–7. https://doi.org/10.1093/gerona/glw140 doi: 10.1093/gerona/glw140. [DOI] [PMC free article] [PubMed]
  50. Petticrew M. Complex Interventions: Some Definitions, Examples and Challenges. URL: www.evidencebasedpublichealth.de/download/Complex\_interventions\_Petticrew.pdf (accessed 19 April 2022).
  51. Petticrew M. When are complex interventions complex? When are simple interventions simple? Eur J Public Health 2011;21:297–8. https://doi.org/10.1093/eurpub/ckr084 doi: 10.1093/eurpub/ckr084. [DOI] [PubMed]
  52. Reeve J, Cooper L, Harrington S, Rosbottom P, Watkins J. Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention. BMC Health Serv Res 2016;16:470. https://doi.org/10.1186/s12913-016-1726-6 doi: 10.1186/s12913-016-1726-6. [DOI] [PMC free article] [PubMed]
  53. Meads C, Nyssen OP, Wong G, Steed L, Bourke L, Ross CA, et al. Protocol for an HTA report: does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling. BMJ Open 2014;4:e004377. https://doi.org/10.1136/bmjopen-2013-004377 doi: 10.1136/bmjopen-2013-004377. [DOI] [PMC free article] [PubMed]
  54. Rycroft-Malone J, McCormack B, Hutchinson AM, DeCorby K, Bucknall TK, Kent B, et al. Realist synthesis: illustrating the method for implementation research. Implement Sci 2012;7:33. https://doi.org/10.1186/1748-5908-7-33 doi: 10.1186/1748-5908-7-33. [DOI] [PMC free article] [PubMed]
  55. Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review – a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy 2005;10(Suppl. 1):21–34. https://doi.org/10.1258/1355819054308530 doi: 10.1258/1355819054308530. [DOI] [PubMed]
  56. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19–32. https://doi.org/10.1080/1364557032000119616 doi: 10.1080/1364557032000119616. [DOI]
  57. Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc 2015;13:141–6. https://doi.org/10.1097/XEB.0000000000000050 doi: 10.1097/XEB.0000000000000050. [DOI] [PubMed]
  58. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci 2010;5:69. https://doi.org/10.1186/1748-5908-5-69 doi: 10.1186/1748-5908-5-69. [DOI] [PMC free article] [PubMed]
  59. Quan H, Li B, Couris CM, Fushimi K, Graham P, Hider P, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 2011;173:676–82. https://doi.org/10.1093/aje/kwq433 doi: 10.1093/aje/kwq433. [DOI] [PubMed]
  60. Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E. Towards a methodology for cluster searching to provide conceptual and contextual ‘richness’ for systematic reviews of complex interventions: case study (CLUSTER). BMC Med Res Methodol 2013;13:118. https://doi.org/10.1186/1471-2288-13-118 doi: 10.1186/1471-2288-13-118. [DOI] [PMC free article] [PubMed]
  61. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. https://doi.org/10.1136/bmj.g1687 doi: 10.1136/bmj.g1687. [DOI] [PubMed]
  62. O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, et al. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol 2014;67:56–64. https://doi.org/10.1016/j.jclinepi.2013.08.005 doi: 10.1016/j.jclinepi.2013.08.005. [DOI] [PubMed]
  63. Reeve E, Thompson W, Farrell B. Deprescribing: a narrative review of the evidence and practical recommendations for recognizing opportunities and taking action. Eur J Intern Med 2017;38:3–11. https://doi.org/10.1016/j.ejim.2016.12.021 doi: 10.1016/j.ejim.2016.12.021. [DOI] [PubMed]
  64. Rohwer A, Booth A, Pfadenhauer L, Brereton L, Gerhardus A, Mozygemba K, et al. Guidance on the Use of Logic Models in Health Technology Assessments of Complex Interventions. URL: www.integrate-hta.eu/wp-content/uploads/2016/02/Guidance-on-the-use-of-logic-models-in-health-technology-assessments-of-complex-interventions.pdf (accessed 16 June 2021).
  65. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Med 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097 doi: 10.1371/journal.pmed.1000097. [DOI] [PMC free article] [PubMed]
  66. Boersma MN, Huibers CJA, Drenth-van Maanen AC, Emmelot-Vonk MH, Wilting I, Knol W. The effect of providing prescribing recommendations on appropriate prescribing: a cluster-randomized controlled trial in older adults in a preoperative setting. Br J Clin Pharmacol 2019;85:1974–83. https://doi.org/10.1111/bcp.13987 doi: 10.1111/bcp.13987. [DOI] [PMC free article] [PubMed]
  67. Caffiero N, Delate T, Ehizuelen MD, Vogel K. Effectiveness of a clinical pharmacist medication therapy management program in discontinuation of drugs to avoid in the elderly. J Manag Care Spec Pharm 2017;23:525–31. https://doi.org/10.18553/jmcp.2017.23.5.525 doi: 10.18553/jmcp.2017.23.5.525. [DOI] [PMC free article] [PubMed]
  68. Campins L, Serra-Prat M, Gózalo I, López D, Palomera E, Agustí C, et al. Randomized controlled trial of an intervention to improve drug appropriateness in community-dwelling polymedicated elderly people. Fam Pract 2017;34:36–42. https://doi.org/10.1093/fampra/cmw073 doi: 10.1093/fampra/cmw073. [DOI] [PubMed]
  69. Chiarelli MT, Antoniazzi S, Cortesi L, Pasina L, Novella A, Venturini F, et al. Pharmacist-driven medication recognition/reconciliation in older medical patients. Eur J Intern Med 2020;83:39–44. https://doi.org/10.1016/j.ejim.2020.07.011 doi: 10.1016/j.ejim.2020.07.011. [DOI] [PubMed]
  70. Curtin D, Jennings E, Daunt R, Curtin S, Randles M, Gallagher P, O’Mahony D. Deprescribing in older people approaching end of life: a randomized controlled trial using STOPP Frail Criteria. J Am Geriatr Soc 2020;68:762–9. https://doi.org/10.1111/jgs.16278 doi: 10.1111/jgs.16278. [DOI] [PubMed]
  71. Fried TR, Niehoff KM, Street RL, Charpentier PA, Rajeevan N, Miller PL, et al. Effect of the tool to reduce inappropriate medications on medication communication and deprescribing. J Am Geriatr Soc 2017;65:2265–71. https://doi.org/10.1111/jgs.15042 doi: 10.1111/jgs.15042. [DOI] [PMC free article] [PubMed]
  72. Köberlein-Neu J, Mennemann H, Hamacher S, Waltering I, Jaehde U, Schaffert C, Rose O. Interprofessional medication management in patients with multiple morbidities. Dtsch Arztebl Int 2016;113:741–8. https://doi.org/10.3238/arztebl.2016.741 doi: 10.3238/arztebl.2016.741. [DOI] [PMC free article] [PubMed]
  73. Komagamine J, Hagane K. Intervention to improve the appropriate use of polypharmacy for older patients with hip fractures: an observational study. BMC Geriatr 2017;17:288. https://doi.org/10.1186/s12877-017-0681-3 doi: 10.1186/s12877-017-0681-3. [DOI] [PMC free article] [PubMed]
  74. Komagamine J, Sugawara K, Hagane K. Characteristics of elderly patients with polypharmacy who refuse to participate in an in-hospital deprescribing intervention: a retrospective cross-sectional study. BMC Geriatr 2018;18:96. https://doi.org/10.1186/s12877-018-0788-1 doi: 10.1186/s12877-018-0788-1. [DOI] [PMC free article] [PubMed]
  75. McCarthy C, Clyne B, Corrigan D, Boland F, Wallace E, Moriarty F, et al. Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot. Implement Sci 2017;12:99. https://doi.org/10.1186/s13012-017-0629-1 doi: 10.1186/s13012-017-0629-1. [DOI] [PMC free article] [PubMed]
  76. McDonald EG, Wu PE, Rashidi B, Forster AJ, Huang A, Pilote L, et al. The MedSafer Study: a controlled trial of an electronic decision support tool for deprescribing in acute care. J Am Geriatr Soc 2019;67:1843–50. https://doi.org/10.1111/jgs.16040 doi: 10.1111/jgs.16040. [DOI] [PubMed]
  77. Muth C, Harder S, Uhlmann L, Rochon J, Fullerton B, Güthlin C, et al. Pilot study to test the feasibility of a trial design and complex intervention on PRIoritising MUltimedication in Multimorbidity in general practices (PRIMUMpilot). BMJ Open 2016;6:e011613. https://doi.org/10.1136/bmjopen-2016-011613 doi: 10.1136/bmjopen-2016-011613. [DOI] [PMC free article] [PubMed]
  78. Muth C, Uhlmann L, Haefeli WE, Rochon J, van den Akker M, Perera R, et al. Effectiveness of a complex intervention on Prioritising Multimedication in Multimorbidity (PRIMUM) in primary care: results of a pragmatic cluster randomised controlled trial. BMJ Open 2018;8:e017740. https://doi.org/10.1136/bmjopen-2017-017740 doi: 10.1136/bmjopen-2017-017740. [DOI] [PMC free article] [PubMed]
  79. Petersen AW, Shah AS, Simmons SF, Shotwell MS, Jacobsen JML, Myers AP, et al. Shed-MEDS: pilot of a patient-centred deprescribing framework reduces medications in hospitalized older adults being transferred to inpatient postacute care. Ther Adv Drug Saf 2018;9:523–33. https://doi.org/10.1177/2042098618781524 doi: 10.1177/2042098618781524. [DOI] [PMC free article] [PubMed]
  80. Martín Lesende I, Mendibil Crespo I, Maiz López G, Gabilondo Zelaia I, Aretxabaleta Parra JC, Mota Goicoechea A. Potentiality of STOPP/START criteria used in primary care to effectively change inappropriate prescribing in elderly patients. Eur Geriatr Med 2013;4:293–8. https://doi.org/10.1016/j.eurger.2013.06.006 doi: 10.1016/j.eurger.2013.06.006. [DOI]
  81. Potter EL, Lew TE, Sooriyakumaran M, Edwards AM, Tong E, Aung AK. Evaluation of pharmacist-led physician-supported inpatient deprescribing model in older patients admitted to an acute general medical unit. Australas J Ageing 2019;38:206–10. https://doi.org/10.1111/ajag.12643 doi: 10.1111/ajag.12643. [DOI] [PubMed]
  82. Russell P, Laubscher S, Roberts GW, Mangoni AA, McDonald C, Hendrix I, et al. A pilot cohort study of deprescribing for nursing home patients acutely admitted to hospital. Ther Adv Drug Saf 2019;10:2042098619854876. https://doi.org/10.1177/2042098619854876 doi: 10.1177/2042098619854876. [DOI] [PMC free article] [PubMed]
  83. San-Jose A, Perez-Bocanegra C, Agusti A, Laorden H, Gost J, Vidal X, et al. Integrated health intervention on polypharmacy and inappropriate prescribing in elderly people with multimorbidity: results at the end of the intervention and at 6 months after the intervention. Med Clin (Barc) 2021;156:263–9. https://doi.org/10.1016/j.medcli.2020.04.030 doi: 10.1016/j.medcli.2020.04.030. [DOI] [PubMed]
  84. van Summeren JJ, Schuling J, Haaijer-Ruskamp FM, Denig P. Outcome prioritisation tool for medication review in older patients with multimorbidity: a pilot study in general practice. Br J Gen Pract 2017;67:e501–6. https://doi.org/10.3399/bjgp17X690485 doi: 10.3399/bjgp17X690485. [DOI] [PMC free article] [PubMed]
  85. Zechmann S, Trueb C, Valeri F, Streit S, Senn O, Neuner-Jehle S. Barriers and enablers for deprescribing among older, multimorbid patients with polypharmacy: an explorative study from Switzerland. BMC Fam Pract 2019;20:64. https://doi.org/10.1186/s12875-019-0953-4 doi: 10.1186/s12875-019-0953-4. [DOI] [PMC free article] [PubMed]
  86. Ghibelli S, Marengoni A, Djade CD, Nobili A, Tettamanti M, Franchi C, et al. Prevention of inappropriate prescribing in hospitalized older patients using a computerized prescription support system (INTERcheck®). Drugs Aging 2013;30:821–8. https://doi.org/10.1007/s40266-013-0109-5 doi: 10.1007/s40266-013-0109-5. [DOI] [PubMed]
  87. Meulendijk MC, Spruit MR, Drenth-van Maanen AC, Numans ME, Brinkkemper S, Jansen PAF, Knol W. Computerized decision support improves medication review effectiveness: an experiment evaluating the STRIP Assistant’s usability. Drugs Aging 2015;32:495–503. https://doi.org/10.1007/s40266-015-0270-0 doi: 10.1007/s40266-015-0270-0. [DOI] [PMC free article] [PubMed]
  88. Willeboordse F, Schellevis FG, Hung Chau S, Hugtenburg JG, Elders PJM. The effectiveness of optimised clinical medication reviews for geriatric patients: Opti-Med a cluster randomised controlled trial. Fam Pract 2017;34:437–45. https://doi.org/10.1093/fampra/cmx007 doi: 10.1093/fampra/cmx007. [DOI] [PubMed]
  89. Niehoff KM, Rajeevan N, Charpentier PA, Miller PL, Goldstein MK, Fried TR. Development of the Tool to Reduce Inappropriate Medications (TRIM): a clinical decision support system to improve medication prescribing for older adults. Pharmacotherapy 2016;36:694–701. https://doi.org/10.1002/phar.1751 doi: 10.1002/phar.1751. [DOI] [PMC free article] [PubMed]
  90. Delgado E, Munõz M, Montero B, Sánchez C, Gallagher PF, Cruz-Jentoft AJ. [Inappropriate prescription in older patients: the STOPP/START criteria.] Rev Esp Geriatr Gerontol 2009;44:273–9. https://doi.org/10.1016/j.regg.2009.03.017 doi: 10.1016/j.regg.2009.03.017. [DOI] [PubMed]
  91. Gallagher P, O’Mahony D. STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing 2008;37:673–9. https://doi.org/10.1093/ageing/afn197 doi: 10.1093/ageing/afn197. [DOI] [PubMed]
  92. Lavan AH, Gallagher P, Parsons C, O’Mahony D. STOPPFrail (screening tool of older persons prescriptions in frail adults with limited life expectancy): consensus validation. Age Ageing 2017;46:600–7. https://doi.org/10.1093/ageing/afx005 doi: 10.1093/ageing/afx005. [DOI] [PubMed]
  93. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012;60:616–31. https://doi.org/10.1111/j.1532-5415.2012.03923.x doi: 10.1111/j.1532-5415.2012.03923.x. [DOI] [PMC free article] [PubMed]
  94. American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2015;63:2227–46. https://doi.org/10.1111/jgs.13702 doi: 10.1111/jgs.13702. [DOI] [PubMed]
  95. Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med 2010;170:1648–54. https://doi.org/10.1001/archinternmed.2010.355 doi: 10.1001/archinternmed.2010.355. [DOI] [PubMed]
  96. Drenth-van Maanen AC, Spee J, van Hensbergen L, Jansen PAF, Egberts TCG, van Marum RJ. Structured history taking of medication use reveals iatrogenic harm due to discrepancies in medication histories in hospital and pharmacy records. J Am Geriatr Soc 2011;59:1976–7. https://doi.org/10.1111/j.1532-5415.2011.03610\_11.x doi: 10.1111/j.1532-5415.2011.03610_11.x. [DOI] [PubMed]
  97. Holmes HM, Hayley DC, Alexander GC, Sachs GA. Reconsidering medication appropriateness for patients late in life. Arch Intern Med 2006;166:605–9. https://doi.org/10.1001/archinte.166.6.605 doi: 10.1001/archinte.166.6.605. [DOI] [PubMed]
  98. Scott IA, Gray LC, Martin JH, Mitchell CA. Minimizing inappropriate medications in older populations: a 10-step conceptual framework. Am J Med 2012;125:529–37.e4. https://doi.org/10.1016/j.amjmed.2011.09.021 doi: 10.1016/j.amjmed.2011.09.021. [DOI] [PubMed]
  99. O’Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner KM, et al. Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open 2019;9:e029954. https://doi.org/10.1136/bmjopen-2019-029954 doi: 10.1136/bmjopen-2019-029954. [DOI] [PMC free article] [PubMed]
  100. Pollmann AS, Murphy AL, Bergman JC, Gardner DM. Deprescribing benzodiazepines and Z-drugs in community-dwelling adults: a scoping review. BMC Pharmacol Toxicol 2015;16:19. https://doi.org/10.1186/s40360-015-0019-8 doi: 10.1186/s40360-015-0019-8. [DOI] [PMC free article] [PubMed]
  101. Rosbach M, Anderson JS. Patient-experienced burden of treatment in patients living with multimorbidity. PLOS ONE 2017;12:e0179916 https://doi.org/10.1371/journal.pone.0179916 doi: 10.1371/journal.pone.0179916. [DOI] [PMC free article] [PubMed]
  102. Taylor-Robinson DC, Smyth RL, Diggle PJ, Whitehead M. The effect of social deprivation on clinical outcomes and the use of treatments in the UK cystic fibrosis population: a longitudinal study. Lancet Respir Med 2013;1:121–8. https://doi.org/10.1016/S2213-2600(13)70002-X doi: 10.1016/S2213-2600(13)70002-X. [DOI] [PMC free article] [PubMed]
  103. Beuscart JB, Knol W, Cullinan S, Schneider C, Dalleur O, Boland B, et al. International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy. BMC Med 2018;16:21. https://doi.org/10.1186/s12916-018-1007-9 doi: 10.1186/s12916-018-1007-9. [DOI] [PMC free article] [PubMed]
  104. Rankin A, Cadogan CA, Ryan C, Clyne B, Smith SM, Hughes CM. Core outcome set for trials aimed at improving the appropriateness of polypharmacy in older people in primary care. J Am Geriatr Soc 2018;66:1206–12. https://doi.org/10.1111/jgs.15245 doi: 10.1111/jgs.15245. [DOI] [PubMed]
  105. Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev 2018;9:CD008165. https://doi.org/10.1002/14651858.CD008165.pub4 doi: 10.1002/14651858.CD008165.pub4. [DOI] [PMC free article] [PubMed]
  106. Wong G, Greenhalgh T, Westhorp G, Pawson R. Development of methodological guidance, publication standards and training materials for realist and meta-narrative reviews: the RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) project. Health Serv Deliv Res 2014;2(30). https://doi.org/10.3310/hsdr02300 doi: 10.3310/hsdr02300. [DOI] [PubMed]
  107. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012;380:37–43. https://doi.org/10.1016/S0140-6736(12)60240-2 doi: 10.1016/S0140-6736(12)60240-2. [DOI] [PubMed]
  108. Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendation for specifying and reporting. Implement Sci 2013;8:139. https://doi.org/10.1186/1748-5908-8-139 doi: 10.1186/1748-5908-8-139. [DOI] [PMC free article] [PubMed]
  109. Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs 2009;12:99–101. https://doi.org/10.1136/ebn.12.4.99-b doi: 10.1136/ebn.12.4.99-b. [DOI] [PubMed]
  110. Grimes DA, Schulz KF. An overview of clinical research: the lay of the land. Lancet 2002;359:57–61. https://doi.org/10.1016/S0140-6736(02)07283-5 doi: 10.1016/S0140-6736(02)07283-5. [DOI] [PubMed]
  111. Doherty AJ, Boland P, Reed J, Clegg AJ, Stephani AM, Williams NH, et al. Barriers and facilitators to deprescribing in primary care: a systematic review. BJGP Open 2020;4:bjgpopen20X101096. https://doi.org/10.3399/bjgpopen20X101096 doi: 10.3399/bjgpopen20X101096. [DOI] [PMC free article] [PubMed]
  112. Ahmad A, Hugtenburg J, Welschen LM, Dekker JM, Nijpels G. Effect of medication review and cognitive behaviour treatment by community pharmacists of patients discharged from the hospital on drug related problems and compliance: design of a randomized controlled trial. BMC Public Health 2010;10:133. https://doi.org/10.1186/1471-2458-10-133 doi: 10.1186/1471-2458-10-133. [DOI] [PMC free article] [PubMed]
  113. Ailabouni NJ, Nishtala PS, Mangin D, Tordoff JM. General practitioners’ insight into deprescribing for the multimorbid older individual: a qualitative study. Int J Clin Pract 2016;70:261–76. https://doi.org/10.1111/ijcp.12780 doi: 10.1111/ijcp.12780. [DOI] [PubMed]
  114. Akinbolade O, Husband A, Forrest S, Todd A. Deprescribing in advanced illness. Prog Palliat Care 2016;24:268–71. https://doi.org/10.1080/09699260.2016.1192321 doi: 10.1080/09699260.2016.1192321. [DOI]
  115. Al Shemeili S, Klein S, Strath A, Fares S, Stewart D. An exploration of health professionals’ experiences of medicines management in elderly, hospitalised patients in Abu Dhabi. Int J Clin Pharm 2016;38:107–18. https://doi.org/10.1007/s11096-015-0212-2 doi: 10.1007/s11096-015-0212-2. [DOI] [PubMed]
  116. Altiner A, Schäfer I, Mellert C, Löffler C, Mortsiefer A, Ernst A, et al. Activating GENeral practitioners dialogue with patients on their Agenda (MultiCare AGENDA) study protocol for a cluster randomized controlled trial. BMC Fam Pract 2012;13:118. https://doi.org/10.1186/1471-2296-13-118 doi: 10.1186/1471-2296-13-118. [DOI] [PMC free article] [PubMed]
  117. Anderson K, Foster M, Freeman C, Luetsch K, Scott I. Negotiating ‘unmeasurable harm and benefit’: perspectives of general practitioners and consultant pharmacists on deprescribing in the primary care setting. Qual Health Res 2017;27:1936–47. https://doi.org/10.1177/1049732316687732 doi: 10.1177/1049732316687732. [DOI] [PubMed]
  118. Baqir W, Barrett S, Desai N, Copeland R, Hughes J. A clinico-ethical framework for multidisciplinary review of medication in nursing homes. BMJ Qual Improv Rep 2014;3:u203261.w2538. https://doi.org/10.1136/bmjquality.u203261.w2538 doi: 10.1136/bmjquality.u203261.w2538. [DOI] [PMC free article] [PubMed]
  119. Bartlett Ellis RJ, Welch JL. Medication-taking behaviours in chronic kidney disease with multiple chronic conditions: a meta-ethnographic synthesis of qualitative studies. J Clin Nurs 2017;26:586–98. https://doi.org/10.1111/jocn.13588 doi: 10.1111/jocn.13588. [DOI] [PubMed]
  120. Bokhof B, Junius-Walker U. Reducing polypharmacy from the perspectives of general practitioners and older patients: a synthesis of qualitative studies. Drugs Aging 2016;33:249–66. https://doi.org/10.1007/s40266-016-0354-5 doi: 10.1007/s40266-016-0354-5. [DOI] [PubMed]
  121. Bolmsjö BB, Palagyi A, Keay L, Potter J, Lindley RI. Factors influencing deprescribing for residents in Advanced Care Facilities: insights from General Practitioners in Australia and Sweden. BMC Fam Pract 2016;17:152. https://doi.org/10.1186/s12875-016-0551-7 doi: 10.1186/s12875-016-0551-7. [DOI] [PMC free article] [PubMed]
  122. Cashman J, Wright J, Ring A. The treatment of co-morbidities in older patients with metastatic cancer. Support Care Cancer 2010;18:651–5. https://doi.org/10.1007/s00520-010-0813-1 doi: 10.1007/s00520-010-0813-1. [DOI] [PubMed]
  123. Cenci C. Narrative medicine and the personalisation of treatment for elderly patients. Eur J Intern Med 2016;32:22–5. https://doi.org/10.1016/j.ejim.2016.05.003 doi: 10.1016/j.ejim.2016.05.003. [DOI] [PubMed]
  124. Centeno M, Fullerton C. Got pills? A pharmacist’s impact on chronic disease and older adults in transitions of care. Int J Qual Heal Care 2016;28:25. https://doi.org/10.1093/intqhc/mzw104.35 doi: 10.1093/intqhc/mzw104.35. [DOI]
  125. Chen Z, Buonanno A. Geriatric polypharmacy: two physicians’ personal perspectives. Clin Geriatr Med 2017;33:283–8. https://doi.org/10.1016/j.cger.2017.01.008 doi: 10.1016/j.cger.2017.01.008. [DOI] [PubMed]
  126. Cheraghi-Sohi S, Jeffries M, Stevenson F, Ashcroft DM, Carr M, Oliver K, Rogers A. The influence of personal communities on the self-management of medication taking: a wider exploration of medicine work. Chronic Illn 2015;11:77–92. https://doi.org/10.1177/1742395314537841 doi: 10.1177/1742395314537841. [DOI] [PubMed]
  127. Christensen LD, Petersen J, Andersen O, Kaae S. Physicians’ non-uniform approach to prescribing drugs to older patients – a qualitative study. Basic Clin Pharmacol Toxicol 2017;121:505–11. https://doi.org/10.1111/bcpt.12837 doi: 10.1111/bcpt.12837. [DOI] [PubMed]
  128. Cimmino K, Pisano M. A patient’s last wish at end-of-life. J Am Geriatr Soc 2016;1:375–80. https://doi.org/10.4140/TCP.n.2016.375 doi: 10.4140/TCP.n.2016.375. [DOI]
  129. Clyne B, Cooper JA, Hughes CM, Fahey T, Smith SM, OPTI-SCRIPT study team. ‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people. BMC Fam Pract 2016;17:109. https://doi.org/10.1186/s12875-016-0507-y doi: 10.1186/s12875-016-0507-y. [DOI] [PMC free article] [PubMed]
  130. Cullinan S, Raae Hansen C, Byrne S, O’Mahony D, Kearney P, Sahm L. Challenges of deprescribing in the multimorbid patient. Eur J Hosp Pharm 2017;24:43–6. https://doi.org/10.1136/ejhpharm-2016-000921 doi: 10.1136/ejhpharm-2016-000921. [DOI] [PMC free article] [PubMed]
  131. Cullinan S, Fleming A, O’Mahony D, Ryan C, O’Sullivan D, Gallagher P, Byrne S. Doctors’ perspectives on the barriers to appropriate prescribing in older hospitalized patients: a qualitative study. Br J Clin Pharmacol 2015;79:860–9. https://doi.org/10.1111/bcp.12555 doi: 10.1111/bcp.12555. [DOI] [PMC free article] [PubMed]
  132. Djatche L, Lee S, Singer D, Hegarty SE, Lombardi M, Maio V. How confident are physicians in deprescribing for the elderly and what barriers prevent deprescribing? J Clin Pharm Ther 2018;43:550–5. https://doi.org/10.1111/jcpt.12688 doi: 10.1111/jcpt.12688. [DOI] [PubMed]
  133. Drenth-van Maanen AC, Leendertse AJ, Jansen PAF, Knol W, Keijsers CJPW, Meulendijk MC, van Marum RJ. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP): combining implicit and explicit prescribing tools to improve appropriate prescribing. J Eval Clin Pract 2018;24:317–22. https://doi.org/10.1111/jep.12787 doi: 10.1111/jep.12787. [DOI] [PubMed]
  134. Duncan P, Duerden M, Payne RA. Deprescribing: a primary care perspective. Eur J Hosp Pharm 2017;24:37–42. https://doi.org/10.1136/ejhpharm-2016-000967 doi: 10.1136/ejhpharm-2016-000967. [DOI] [PMC free article] [PubMed]
  135. Edelman M, Jellema P, Hak E, Denig P, Blanker MH. Patients’ attitudes towards deprescribing alpha-blockers and their willingness to participate in a discontinuation trial. Drugs Aging 2019;36:1133–9. https://doi.org/10.1007/s40266-019-00712-6 doi: 10.1007/s40266-019-00712-6. [DOI] [PMC free article] [PubMed]
  136. Elliott RA, Ross-Degnan D, Adams AS, Safran DG, Soumerai SB. Strategies for coping in a complex world: adherence behavior among older adults with chronic illness. J Gen Intern Med 2007;22:805–10. https://doi.org/10.1007/s11606-007-0193-5 doi: 10.1007/s11606-007-0193-5. [DOI] [PMC free article] [PubMed]
  137. Frank C. Deprescribing: a new word to guide medication review. CMAJ 2014;186:407–8. https://doi.org/10.1503/cmaj.131568 doi: 10.1503/cmaj.131568. [DOI] [PMC free article] [PubMed]
  138. Garfinkel D, IGRIMUP. Overview of current and future research and clinical directions for drug discontinuation: psychological, traditional and professional obstacles to deprescribing. Eur J Hosp Pharm 2017;24:16–20. https://doi.org/10.1136/ejhpharm-2016-000959 doi: 10.1136/ejhpharm-2016-000959. [DOI] [PMC free article] [PubMed]
  139. Gaup MA, Halvorsen KH. Physicians’ experiences with NORGEP criteria and the use of inappropriate medication in elderly patients in nursing home and home care service. Int J Clin Pharm 2015;37:14–15.
  140. Geijteman ECT, Huisman BAA, Dees MK, Perez RSGM, van der Rijt CCD, van Zuylen L, van der Heide A. Medication discontinuation at the end of life: a questionnaire study on physicians’ experiences and opinions. J Palliat Med 2018;21:1166–70. https://doi.org/10.1089/jpm.2017.0501 doi: 10.1089/jpm.2017.0501. [DOI] [PubMed]
  141. Gillespie R, Mullan J, Harrison L. Deprescribing for older adults in Australia: factors influencing GPs. Aust J Prim Health 2018;24:463–9. https://doi.org/10.1071/PY18056 doi: 10.1071/PY18056. [DOI] [PubMed]
  142. Gnjidic D, Le Couteur DG, Kouladjian L, Hilmer SN. Deprescribing trials: methods to reduce polypharmacy and the impact on prescribing and clinical outcomes. Clin Geriatr Med 2012;28:237–53. https://doi.org/10.1016/j.cger.2012.01.006 doi: 10.1016/j.cger.2012.01.006. [DOI] [PubMed]
  143. Gnjidic D, Le Couteur DG, Hilmer SN. Discontinuing drug treatments: we need better evidence to guide deprescribing. BMJ 2014;349:g7013. https://doi.org/10.1136/bmj.g7013 doi: 10.1136/bmj.g7013. [DOI] [PubMed]
  144. Gonçalves F. Deprescription in advanced cancer patients. Pharmacy 2018;6:E88. https://doi.org/10.3390/pharmacy6030088 doi: 10.3390/pharmacy6030088. [DOI] [PMC free article] [PubMed]
  145. Hardy JE, Hilmer SN. Deprescribing in the last year of life. J Pharm Pract Res 2011;41:146–51. https://doi.org/10.1002/j.2055-2335.2011.tb00684.x doi: 10.1002/j.2055-2335.2011.tb00684.x. [DOI]
  146. Harriman K, Howard L, McCracken R. Deprescribing medication for frail elderly patients: a survey of Vancouver family physicians. BCMJ 2014;56:436–41.
  147. Hasler S, Senn O, Rosemann T, Neuner-Jehle S. Effect of a patient-centered drug review on polypharmacy in primary care patients: study protocol for a cluster-randomized controlled trial. Trials 2015;16:380. https://doi.org/10.1186/s13063-015-0915-7 doi: 10.1186/s13063-015-0915-7. [DOI] [PMC free article] [PubMed]
  148. Hernandez J. Medication management in the older adult: a narrative exploration. J Am Assoc Nurse Pract 2017;29:186–94. https://doi.org/10.1002/2327-6924.12427 doi: 10.1002/2327-6924.12427. [DOI] [PubMed]
  149. Hilmer SN, Gnjidic D, Le Couteur DG. Thinking through the medication list – appropriate prescribing and deprescribing in robust and frail older patients. Aust Fam Physician 2012;41:924–8. [PubMed]
  150. Howland RH. Questions to ask when selecting medication. J Psychosoc Nurs Ment Health Serv 2012;50:13–15. https://doi.org/10.3928/02793695-20120607-01 doi: 10.3928/02793695-20120607-01. [DOI] [PubMed]
  151. Jäger C, Steinhaeuser J, Freund T, Szecsenyi J, Goetz K. Medication lists and brown bag reviews: potential positive and negative impacts on patients beliefs about their medicine. Biomed Res Int 2015;2015:874067. https://doi.org/10.1155/2015/874067 doi: 10.1155/2015/874067. [DOI] [PMC free article] [PubMed]
  152. Jansen J, McKinn S, Bonner C, Irwig L, Doust J, Glasziou P, et al. General practitioners’ decision making about primary prevention of cardiovascular disease in older adults: a qualitative study. PLOS ONE 2017;12:e0170228. https://doi.org/10.1371/journal.pone.0170228 doi: 10.1371/journal.pone.0170228. [DOI] [PMC free article] [PubMed]
  153. Jones BA. Decreasing polypharmacy in clients most at risk. AACN Clin Issues 1997;8:627–34. https://doi.org/10.1097/00044067-199711000-00014 doi: 10.1097/00044067-199711000-00014. [DOI] [PubMed]
  154. Kaufman G, Bellerby A, Kitching M. Considering patient experience and evidence-based choice of medicines in medicines optimisation. Nurs Stand 2017;31:54–63. https://doi.org/10.7748/ns.2017.e10883 doi: 10.7748/ns.2017.e10883. [DOI] [PubMed]
  155. Knowles S, Hays R, Senra H, Bower P, Locock L, Protheroe J, et al. Empowering people to help speak up about safety in primary care: Using codesign to involve patients and professionals in developing new interventions for patients with multimorbidity. Health Expect 2018;21:539–48. https://doi.org/10.1111/hex.12648 doi: 10.1111/hex.12648. [DOI] [PMC free article] [PubMed]
  156. Köberlein J, Gottschall M, Czarnecki K, Thomas A, Bergmann A, Voigt K. General practitioners’ views on polypharmacy and its consequences for patient health care. BMC Fam Pract 2013;14:119. https://doi.org/10.1186/1471-2296-14-119 doi: 10.1186/1471-2296-14-119. [DOI] [PMC free article] [PubMed]
  157. Krska J. Factoring in frailty when optimising medication. Prescriber 2018;29:32–4. https://doi.org/10.1002/psb.1698 doi: 10.1002/psb.1698. [DOI]
  158. Krska J, Morecroft CW, Rowe PH, Poole H. Measuring the impact of long-term medicines use from the patient perspective. Int J Clin Pharm 2014;36:675–8. https://doi.org/10.1007/s11096-014-9970-5 doi: 10.1007/s11096-014-9970-5. [DOI] [PubMed]
  159. Kuruvilla L, Weeks G, Eastman P, George J. Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: a qualitative exploration of consumer and health care professional perspectives. Palliat Med 2018;32:1369–77. https://doi.org/10.1177/0269216318777390 doi: 10.1177/0269216318777390. [DOI] [PubMed]
  160. Laursen J, Kornholt J, Betzer C, Petersen TS, Christensen MB. General practitioners’ barriers toward medication reviews in polymedicated multimorbid patients: how can a focus on the pharmacotherapy in an outpatient clinic support GPs? Health Serv Res Manag Epidemiol 2018;5. https://doi.org/10.1177/2333392818792169 doi: 10.1177/2333392818792169. [DOI] [PMC free article] [PubMed]
  161. Maidment I, Booth A, Mullan J, McKeown J, Bailey S, Wong G. Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE) – a realist synthesis. Syst Rev 2017;6:125. https://doi.org/10.1186/s13643-017-0528-1 doi: 10.1186/s13643-017-0528-1. [DOI] [PMC free article] [PubMed]
  162. Manias E, Claydon-Platt K, McColl GJ, Bucknall TK, Brand CA. Managing complex medication regimens: perspectives of consumers with osteoarthritis and healthcare professionals. Ann Pharmacother 2007;41:764–71. https://doi.org/10.1345/aph.1H623 doi: 10.1345/aph.1H623. [DOI] [PubMed]
  163. Mantelli S, Jungo KT, Rozsnyai Z, Reeve E, Luymes CH, Poortvliet RKE, et al. How general practitioners would deprescribe in frail oldest-old with polypharmacy – the LESS study. BMC Fam Pract 2018;19:169. https://doi.org/10.1186/s12875-018-0856-9 doi: 10.1186/s12875-018-0856-9. [DOI] [PMC free article] [PubMed]
  164. Marengoni A, Nobili A, Onder G. Best practices for drug prescribing in older adults: a call for action. Drugs Aging 2015;32:887–90. https://doi.org/10.1007/s40266-015-0324-3 doi: 10.1007/s40266-015-0324-3. [DOI] [PubMed]
  165. McGrath K, Hajjar ER, Kumar C, Hwang C, Salzman B. Deprescribing: a simple method for reducing polypharmacy. J Fam Pract 2017;66:436–45. [PubMed]
  166. Mc Namara KP, Breken BD, Alzubaidi HT, Bell JS, Dunbar JA, Walker C, Hernan A. Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia. Age Ageing 2017;46:291–9. https://doi.org/10.1093/ageing/afw200 doi: 10.1093/ageing/afw200. [DOI] [PubMed]
  167. Modig S, Kristensson J, Ekwall AK, Hallberg IR, Midlöv P. Frail elderly patients in primary care – their medication knowledge and beliefs about prescribed medicines. Eur J Clin Pharmacol 2009;65:151–5. https://doi.org/10.1007/s00228-008-0581-8 doi: 10.1007/s00228-008-0581-8. [DOI] [PubMed]
  168. Mudge A, Radnedge K, Kasper K, Mullins R, Adsett J, Rofail S, et al. Effects of a pilot multidisciplinary clinic for frequent attending elderly patients on deprescribing. Aust Health Rev 2016;40:86–91. https://doi.org/10.1071/AH14219 doi: 10.1071/AH14219. [DOI] [PubMed]
  169. Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract 2017;18:70. https://doi.org/10.1186/s12875-017-0642-0 doi: 10.1186/s12875-017-0642-0. [DOI] [PMC free article] [PubMed]
  170. Nadarajan K, Balakrishnan T, Yee ML, Soong JL. The attitudes and beliefs of doctors towards deprescribing medications. Proc Singapore Healthc 2018;27:41–8. https://doi.org/10.1177/2010105817719711 doi: 10.1177/2010105817719711. [DOI]
  171. Naughton C, Hayes N. Deprescribing in older adults: a new concept for nurses in administering medicines and as prescribers of medicine. Eur J Hosp Pharm 2017;24:47–50. https://doi.org/10.1136/ejhpharm-2016-000908 doi: 10.1136/ejhpharm-2016-000908. [DOI] [PMC free article] [PubMed]
  172. Ng WL, Tan MZ, Koh EY, Tan NC. Deprescribing: what are the views and factors influencing this concept among patients with chronic diseases in a developed Asian community? Proc Singapore Healthc 2017;26:172–9. https://doi.org/10.1177/2010105817699633 doi: 10.1177/2010105817699633. [DOI]
  173. Nixon MS, Vendelø MT. General practitioners’ decisions about discontinuation of medication: an explorative study. J Health Organ Manag 2016;30:565–80. https://doi.org/10.1108/JHOM-01-2015-0011 doi: 10.1108/JHOM-01-2015-0011. [DOI] [PubMed]
  174. Frailty, polypharmacy and deprescribing. Drug Ther Bull 2016;54:69–72. https://doi.org/10.1136/dtb.2016.6.0408 doi: 10.1136/dtb.2016.6.0408. [DOI] [PubMed]
  175. Oboh L, Qadir MS. Deprescribing and managing polypharmacy in frail older people: a patient-centred approach in the real world. Eur J Hosp Pharm 2017;24:58–62. https://doi.org/10.1136/ejhpharm-2016-001008 doi: 10.1136/ejhpharm-2016-001008. [DOI] [PMC free article] [PubMed]
  176. O’Brien CP. Withdrawing medication: managing medical comorbidities near the end of life. Can Fam Physician 2011;57:304–7, e89–92. [PMC free article] [PubMed]
  177. Ouellet GM, Ouellet JA, Tinetti ME. Principle of rational prescribing and deprescribing in older adults with multiple chronic conditions. Ther Adv Drug Saf 2018;9:639–52. https://doi.org/10.1177/2042098618791371 doi: 10.1177/2042098618791371. [DOI] [PMC free article] [PubMed]
  178. Page AT, Potter K, Clifford R, Etherton-Beer C. Deprescribing in older people. Maturitas 2016;91:115–34. https://doi.org/10.1016/j.maturitas.2016.06.006 doi: 10.1016/j.maturitas.2016.06.006. [DOI] [PubMed]
  179. Palagyi A, Keay L, Harper J, Potter J, Lindley RI. Barricades and brickwalls – a qualitative study exploring perceptions of medication use and deprescribing in long-term care. BMC Geriatr 2016;16:15. https://doi.org/10.1186/s12877-016-0181-x doi: 10.1186/s12877-016-0181-x. [DOI] [PMC free article] [PubMed]
  180. Rodríguez Pérez A, Alfaro Lara ER, Nieto Martín MD, Ruiz Cantero A, Santos Ramos B. Deprescribing in patients with multimorbidity: a necessary process. Eur J Intern Med 2015;26:e18–9. https://doi.org/10.1016/j.ejim.2015.06.011 doi: 10.1016/j.ejim.2015.06.011. [DOI] [PubMed]
  181. Pitkälä KH, Suominen MH, Bell JS, Strandberg TE. Herbal medications and other dietary supplements. A clinical review for physicians caring for older people. Ann Med 2016;48:586–602. https://doi.org/10.1080/07853890.2016.1197414 doi: 10.1080/07853890.2016.1197414. [DOI] [PubMed]
  182. Le Couteur DG, McLachlan AJ, Hilmer SN. Polypharmacy in older people: when should you deprescribe? Med Today 2016;17:16–24.
  183. Pruskowski J, Handler SM. The DE-PHARM Project: a pharmacist-driven deprescribing initiative in a nursing facility. Consult Pharm 2017;32:468–78. https://doi.org/10.4140/TCP.n.2017.468 doi: 10.4140/TCP.n.2017.468. [DOI] [PubMed]
  184. Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Review of deprescribing processes and development of an evidence-based, patient-centred deprescribing process. Br J Clin Pharmacol 2014;78:738–47. https://doi.org/10.1111/bcp.12386 doi: 10.1111/bcp.12386. [DOI] [PMC free article] [PubMed]
  185. Reeve E, Bell JS, Hilmer SN. Barriers to optimising prescribing and deprescribing in older adults with dementia: a narrative review. Curr Clin Pharmacol 2015;10:168–77. https://doi.org/10.2174/157488471003150820150330 doi: 10.2174/157488471003150820150330. [DOI] [PubMed]
  186. Rieckert A, Sommerauer C, Krumeich A, Sönnichsen A. Reduction of inappropriate medication in older populations by electronic decision support (the PRIMA-eDS study): a qualitative study of practical implementation in primary care. BMC Fam Pract 2018;19:110. https://doi.org/10.1186/s12875-018-0789-3 doi: 10.1186/s12875-018-0789-3. [DOI] [PMC free article] [PubMed]
  187. Rigby D. Medication review: interview crucial to HMR success. Aust J Pharm 2013;94:28–9.
  188. Rose O, Richling I, Voigt K, Gottschall M, Köberlein-Neu J. Patient selection and general practitioners’ perception of collaboration in medication review. Res Soc Adm Pharm 2019;15:521–7. https://doi.org/10.1016/j.sapharm.2018.06.019 doi: 10.1016/j.sapharm.2018.06.019. [DOI] [PubMed]
  189. Ross A, Gillett J. Confronting medicine’s dichotomies: older adults’ use of interpretative repertoires in negotiating the paradoxes of polypharmacy and deprescribing. Qual Health Res 2020;30:448–57. https://doi.org/10.1177/1049732319868981 doi: 10.1177/1049732319868981. [DOI] [PubMed]
  190. Ross A, Gillett J. ‘At 80 I know myself’: embodied learning and older adults’ experiences of polypharmacy and perceptions of deprescribing. Gerontol Geriatr Med 2019;5:2333721419895617. https://doi.org/10.1177/2333721419895617 doi: 10.1177/2333721419895617. [DOI] [PMC free article] [PubMed]
  191. Ross A, Gillett J. Forms of trust and polypharmacy among older adults. Ageing Soc 2020;41:1–16. https://doi.org/10.1017/S0144686X20000483 doi: 10.1017/S0144686X20000483. [DOI]
  192. Ryan R, Hill S. Making rational choices about how best to support consumers’ use of medicines: a perspective review. Ther Adv Drug Saf 2016;7:159–64. https://doi.org/10.1177/2042098616651198 doi: 10.1177/2042098616651198. [DOI] [PMC free article] [PubMed]
  193. Schäfer I, Kaduszkiewicz H, Mellert C, Löffler C, Mortsiefer A, Ernst A, et al. Narrative medicine-based intervention in primary care to reduce polypharmacy: results from the cluster-randomised controlled trial MultiCare AGENDA. BMJ Open 2018;8:e017653. https://doi.org/10.1136/bmjopen-2017-017653 doi: 10.1136/bmjopen-2017-017653. [DOI] [PMC free article] [PubMed]
  194. Schöpf AC, von Hirschhausen M, Farin E, Maun A. Elderly patients’ and GPs’ perspectives of patient–GP communication concerning polypharmacy: a qualitative interview study. Prim Health Care Res Dev 2018;19:355–64. https://doi.org/10.1017/S1463423617000883 doi: 10.1017/S1463423617000883. [DOI] [PMC free article] [PubMed]
  195. Schuling J, Gebben H, Veehof LJ, Haaijer-Ruskamp FM. Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study. BMC Fam Pract 2012;13:56. https://doi.org/10.1186/1471-2296-13-56 doi: 10.1186/1471-2296-13-56. [DOI] [PMC free article] [PubMed]
  196. Scott IA, Gray LC, Martin JH, Pillans PI, Mitchell CA. Deciding when to stop: towards evidence-based deprescribing of drugs in older populations. Evid Based Med 2013;18:121–4. https://doi.org/10.1136/eb-2012-100930 doi: 10.1136/eb-2012-100930. [DOI] [PubMed]
  197. Sheppard JP, Burt J, Lown M, Temple E, Benson J, Ford GA, et al. OPtimising Treatment for MIld Systolic hypertension in the Elderly (OPTiMISE): protocol for a randomised controlled non-inferiority trial. BMJ Open 2018;8:e022930. https://doi.org/10.1136/bmjopen-2018-022930 doi: 10.1136/bmjopen-2018-022930. [DOI] [PMC free article] [PubMed]
  198. Sinnige J, Korevaar JC, van Lieshout J, Westert GP, Schellevis FG, Braspenning JC. Medication management strategy for older people with polypharmacy in general practice: a qualitative study on prescribing behaviour in primary care. Br J Gen Pract 2016;66:e540–51. https://doi.org/10.3399/bjgp16X685681 doi: 10.3399/bjgp16X685681. [DOI] [PMC free article] [PubMed]
  199. Sinnott C, Hugh SM, Boyce MB, Bradley CP. What to give the patient who has everything? A qualitative study of prescribing for multimorbidity in primary care. Br J Gen Pract 2015;65:e184–91. https://doi.org/10.3399/bjgp15X684001 doi: 10.3399/bjgp15X684001. [DOI] [PMC free article] [PubMed]
  200. Sinnott C, Mercer SW, Payne RA, Duerden M, Bradley CP, Byrne M. Improving medication management in multimorbidity: development of the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention using the Behaviour Change Wheel. Implement Sci 2015;10:132. https://doi.org/10.1186/s13012-015-0322-1 doi: 10.1186/s13012-015-0322-1. [DOI] [PMC free article] [PubMed]
  201. Sinnott C, Byrne M, Bradley CP. Improving medication management for patients with multimorbidity in primary care: a qualitative feasibility study of the MY COMRADE implementation intervention. Pilot Feasibility Stud 2017;3:14. https://doi.org/10.1186/s40814-017-0129-8 doi: 10.1186/s40814-017-0129-8. [DOI] [PMC free article] [PubMed]
  202. St Peter WL. Management of polypharmacy in dialysis patients. Semin Dial 2015;28:427–32. https://doi.org/10.1111/sdi.12377 doi: 10.1111/sdi.12377. [DOI] [PubMed]
  203. Steinman MA, Hanlon JT. Managing medications in clinically complex elders: ‘there’s got to be a happy medium’. JAMA 2010;304:1592–601. https://doi.org/10.1001/jama.2010.1482 doi: 10.1001/jama.2010.1482. [DOI] [PMC free article] [PubMed]
  204. Straßner C, Steinhäuser J, Freund T, Szecsenyi J, Wensing M. German healthcare professionals’ perspective on implementing recommendations about polypharmacy in general practice: a qualitative study. Fam Pract 2018;35:503–10. https://doi.org/10.1093/fampra/cmx127 doi: 10.1093/fampra/cmx127. [DOI] [PubMed]
  205. Sun W. A scaling-up approach to educating home care nurses about deprescribing to promote active living of frail older adults at home. J Am Geriatr Soc 2018;66:S83. https://doi.org/10.1093/geroni/igy023.478 doi: 10.1093/geroni/igy023.478. [DOI]
  206. Thomas R, Kilbey C. Complex medicines management. Nurs Times 2011;107:20–2. [PubMed]
  207. Townsend A, Hunt K, Wyke S. Managing multiple morbidity in mid-life: a qualitative study of attitudes to drug use. BMJ 2003;327:837. https://doi.org/10.1136/bmj.327.7419.837 doi: 10.1136/bmj.327.7419.837. [DOI] [PMC free article] [PubMed]
  208. Turner JP, Edwards S, Stanners M, Shakib S, Bell JS. What factors are important for deprescribing in Australian long-term care facilities? Perspectives of residents and health professionals. BMJ Open 2016;6:e009781. https://doi.org/10.1136/bmjopen-2015-009781 doi: 10.1136/bmjopen-2015-009781. [DOI] [PMC free article] [PubMed]
  209. Turner JP, Shakib S, Bell JS. Is my older cancer patient on too many medications? J Geriatr Oncol 2017;8:77–81. https://doi.org/10.1016/j.jgo.2016.10.003 doi: 10.1016/j.jgo.2016.10.003. [DOI] [PubMed]
  210. Twigg MJ, Wright D, Kirkdale CL, Desborough JA, Thornley T. The UK Pharmacy Care Plan service: description, recruitment and initial views on a new community pharmacy intervention. PLOS ONE 2017;12:e0174500. https://doi.org/10.1371/journal.pone.0174500 doi: 10.1371/journal.pone.0174500. [DOI] [PMC free article] [PubMed]
  211. Uhl MC, Muth C, Gerlach FM, Schoch GG, Müller BS. Patient-perceived barriers and facilitators to the implementation of a medication review in primary care: a qualitative thematic analysis. BMC Fam Pract 2018;19:3. https://doi.org/10.1186/s12875-017-0707-0 doi: 10.1186/s12875-017-0707-0. [DOI] [PMC free article] [PubMed]
  212. van Middelaar T, Ivens SD, van Peet PG, Poortvliet RKE, Richard E, Pols AJ, Moll van Charante EP. Prescribing and deprescribing antihypertensive medication in older people by Dutch general practitioners: a qualitative study. BMJ Open 2018;8:e020871. https://doi.org/10.1136/bmjopen-2017-020871 doi: 10.1136/bmjopen-2017-020871. [DOI] [PMC free article] [PubMed]
  213. Vandermause R, Neumiller JJ, Gates BJ, David P, Altman M, Healey DJ, et al. Preserving self: medication-taking practices and preferences of older adults with multiple chronic medical conditions. J Nurs Scholarsh 2016;48:533–42. https://doi.org/10.1111/jnu.12250 doi: 10.1111/jnu.12250. [DOI] [PubMed]
  214. Voigt K, Gottschall M, Köberlein-Neu J, Schübel J, Quint N, Bergmann A. Why do family doctors prescribe potentially inappropriate medication to elderly patients? BMC Fam Pract 2016;17:93. https://doi.org/10.1186/s12875-016-0482-3 doi: 10.1186/s12875-016-0482-3. [DOI] [PMC free article] [PubMed]
  215. Waller DG. Rational prescribing: the principles of drug selection and assessment of efficacy. Clin Med 2005;5:26–8. https://doi.org/10.7861/clinmedicine.5-1-26 doi: 10.7861/clinmedicine.5-1-26. [DOI] [PMC free article] [PubMed]
  216. Wilchesky M, Mueller G, Morin M, Marcotte M, Voyer P, Aubin M, et al. The OptimaMed intervention to reduce inappropriate medications in nursing home residents with severe dementia: results from a quasi-experimental feasibility pilot study. BMC Geriatr 2018;18:204. https://doi.org/10.1186/s12877-018-0895-z doi: 10.1186/s12877-018-0895-z. [DOI] [PMC free article] [PubMed]
  217. Williams ME, Pulliam CC, Hunter R, Johnson TM, Owens JE, Kincaid J, et al. The short-term effect of interdisciplinary medication review on function and cost in ambulatory elderly people. J Am Geriatr Soc 2004;52:93–8. https://doi.org/10.1111/j.1532-5415.2004.52016.x doi: 10.1111/j.1532-5415.2004.52016.x. [DOI] [PubMed]
  218. Weir K, Nickel B, Naganathan V, Bonner C, McCaffery K, Carter SM, et al. Decision-making preferences and deprescribing: perspectives of older adults and companions about their medicines. J Gerontol B Psychol Sci Soc Sci 2018;73:e98–e107. https://doi.org/10.1093/geronb/gbx138 doi: 10.1093/geronb/gbx138. [DOI] [PubMed]
  219. Royal College of General Practitioners. Continuity of Care. URL: www.rcgp.org.uk/clinical-and-research/our-programmes/innovation/continuity-of-care.aspx (accessed 16 June 2021).
  220. Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, Mckendry R. Education and Debate Continuity of Care: A Multidisciplinary Review. URL: www.euro.who.int/AboutWHO/Policy/20010927\_5 (accessed 16 June 2021). doi: 10.1136/bmj.327.7425.1219. [DOI] [PMC free article] [PubMed]
  221. Tarrant C, Dixon-Woods M, Colman AM, Stokes T. Continuity and trust in primary care: a qualitative study informed by game theory. Ann Fam Med 2010;8:440–6. https://doi.org/10.1370/afm.1160 doi: 10.1370/afm.1160. [DOI] [PMC free article] [PubMed]
  222. Mainous AG, Baker R, Love MM, Gray DP, Gill JM. Continuity of care and trust in one’s physician: evidence from primary care in the United States and the United Kingdom. Fam Med 2001;33:22–7. [PubMed]
  223. Kislov R, Hyde P, Mcdonald R, Manchester A. New game, old rules? Mechanisms and consequences of legitimation in boundary spanning activities. Organ Stud 2017;38:1421–44. https://doi.org/10.1177/0170840616679455 doi: 10.1177/0170840616679455. [DOI]
  224. Levina N, Vaast E. The emergence of boundary spanning competence in practice: implications for implementation and use of information systems. MIS Q Manag Inf Syst 2005;29:335–63. https://doi.org/10.2307/25148682 doi: 10.2307/25148682. [DOI]
  225. Dang BN, Westbrook RA, Njue SM, Giordano TP. Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC Med Educ 2017;17:32. https://doi.org/10.1186/s12909-017-0868-5 doi: 10.1186/s12909-017-0868-5. [DOI] [PMC free article] [PubMed]
  226. Skirbekk H, Middelthon AL, Hjortdahl P, Finset A. Mandates of trust in the doctor-patient relationship. Qual Health Res 2011;21:1182–90. https://doi.org/10.1177/1049732311405685 doi: 10.1177/1049732311405685. [DOI] [PubMed]
  227. Petrocchi S, Iannello P, Lecciso F, Levante A, Antonietti A, Schulz PJ. Interpersonal trust in doctor-patient relation: evidence from dyadic analysis and association with quality of dyadic communication. Soc Sci Med 2019;235:112391. https://doi.org/10.1016/j.socscimed.2019.112391 doi: 10.1016/j.socscimed.2019.112391. [DOI] [PubMed]
  228. Hobfoll SE. Conservation of resources. A new attempt at conceptualizing stress. Am Psychol 1989;44:513–24. https://doi.org/10.1037//0003-066x.44.3.513 doi: 10.1037//0003-066x.44.3.513. [DOI] [PubMed]
  229. Halbesleben JRB, Neveu J-P, Westman M. Getting to the ‘COR’: understanding the role of resources in conservation of resources theory. J Manage 2014;40:1334–64. https://doi.org/10.1177/0149206314527130 doi: 10.1177/0149206314527130. [DOI]
  230. Hupcey JE. Clarifying the social support theory-research linkage. J Adv Nurs 1998;27:1231–41. https://doi.org/10.1046/j.1365-2648.1998.01231.x doi: 10.1046/j.1365-2648.1998.01231.x. [DOI] [PubMed]
  231. Leahy-Warren P. Social support theory. In Fitzpatrick JJ, McCarthy G, editors. Theories Guiding Nursing Research and Practice: Making Nursing Knowledge Development Explicit. New York, NY: Springer Publishing Company; 2014. pp. 85–101. https://doi.org/10.1891/9780826164056.0006 doi: 10.1891/9780826164056.0006. [DOI]
  232. Stewart M. Reflections on the doctor-patient relationship: from evidence and experience. Br J Gen Pract 2005;55:793–801. [PMC free article] [PubMed]
  233. NHS England. Shared Decision Making. URL: www.england.nhs.uk/shared-decision-making/ (accessed 16 June 2021).
  234. Crits-Christoph P, Rieger A, Gaines A, Gibbons MBC. Trust and respect in the patient-clinician relationship: preliminary development of a new scale. BMC Psychol 2019;7:91. https://doi.org/10.1186/s40359-019-0347-3 doi: 10.1186/s40359-019-0347-3. [DOI] [PMC free article] [PubMed]
  235. Reeve J, Dickenson M, Harris J, Ranson E, Dohnhammer U, Cooper L, et al. Solutions to problematic polypharmacy: learning from the expertise of patients. Br J Gen Pract 2015;65:319–20. https://doi.org/10.3399/bjgp15X685465 doi: 10.3399/bjgp15X685465. [DOI] [PMC free article] [PubMed]
  236. Grint K. Wicked problems and clumsy solutions: the role of leadership. Clinical Leader 2008;1:54–68.
  237. Department of Health and Social Care. National Overprescribing Review Report. London: Department of Health and Social Care; 2021. URL: www.gov.uk/government/publications/national-overprescribing-review-report (accessed 19 April 2022).
  238. National Institute for Health and Care Excellence (NICE). Multimorbidity: Clinical Assessment and Management. NICE Guideline [NG56]. 2016. URL: www.nice.org.uk/guidance/ng56/resources (accessed 16 June 2021).
  239. Evans S, Scarbrough H. Supporting knowledge translation through collaborative translational research initiatives: ‘bridging’ versus ‘blurring’ boundary-spanning approaches in the UK CLAHRC initiative. Soc Sci Med 2014;106:119–27. https://doi.org/10.1016/j.socscimed.2014.01.025 doi: 10.1016/j.socscimed.2014.01.025. [DOI] [PMC free article] [PubMed]
  240. Green LW. Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence? Fam Pract 2008;25(Suppl. 1):i20–4. https://doi.org/10.1093/fampra/cmn055 doi: 10.1093/fampra/cmn055. [DOI] [PubMed]
  241. Fox GC, Lazar A, Hilton A, Wong G, Maidment I, Khondoker M, et al. The Clinical, Social and Cost Effectiveness of a Decision Support Tool to Optimise Community-Based Tailored Management of Sleep (TIMES) for People Living with Dementia or Mild Cognitive Impairment and Sleep Disturbance: TIMES TaIlored ManagEment of Sleep. URL: https://fundingawards.nihr.ac.uk/award/NIHR202345 (accessed 14 March 2022).
  242. NHS England. Involving People in their Own Care. URL: www.england.nhs.uk/ourwork/patient-participation/ (accessed 16 June 2021).
  243. National Voices. Person-Centred Care in 2017. Evidence from Service Users. URL: www.nationalvoices.org.uk/publications/our-publications/person-centred-care-2017 (accessed 16 June 2021).
  244. Gopichandran V, Wouters E, Chetlapalli SK. Development and validation of a socioculturally competent trust in physician scale for a developing country setting. BMJ Open 2015;5:e007305. https://doi.org/10.1136/bmjopen-2014-007305 doi: 10.1136/bmjopen-2014-007305. [DOI] [PMC free article] [PubMed]
  245. Holzinger A, Carrington A, Muller H. Measuring the Quality of Explanations: The System Causability Scale (SCS). Comparing Human and Machine Explanations. URL: https://arxiv.org/abs/1912.09024 (accessed 16 June 2021). doi: 10.1007/s13218-020-00636-z. [DOI] [PMC free article] [PubMed]
  246. Royal College of Physicians. Avoiding Harm from Over-prescribing: How to Reduce Waste and Dependence on Prescription Drugs. URL: www.rcplondon.ac.uk/events/avoiding-harm-over-prescribing-how-reduce-waste-and-dependence-prescription-drugs (accessed 19 April 2022).