EditorialReducing Polypharmacy: Evidence From a Simple Quality Improvement Initiative
Section snippets
Education
Interprofessional education is needed to see a sustained improvement in medication use in the nursing home setting. All interdisciplinary team members should be informed of changes in geriatric standards of practice, clinical practice guidelines, and updated drug information. In our facility, most educational initiatives focused on nursing staff and prescribers. To successfully reduce the number of medications, nonpharmacologic alternatives were provided to nurses and support staff. In
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Psychotropic polypharmacy reconsidered: Between-class polypharmacy in the context of multimorbidity in the treatment of depressive disorders
2019, Journal of Affective DisordersCitation Excerpt :Such studies would further inform policy guidelines (e.g., implementing value-based quality of care models for prescribing psychotropics) and justify current prescribing practices. Second, there have been efforts at discouraging presumably unnecessary psychotropic polypharmacy through quality assurance and performance improvement initiatives (Goren et al., 2008; Little and Morley, 2013), physician training programs (Tamura et al., 2011), and by developing and disseminating explicit criteria (Preskorn and Lacey, 2007) to reduce polypharmacy (e.g., Beers criteria (American Geriatrics Society Beers Criteria Update Expert Panel 2015) for older adults). Despite these efforts, our study suggests that the psychotropic polypharmacy is still common in adults with depressive disorders and that such polypharmacy is potentially justified as individualized treatments of multimorbidity.
A Decade of JAMDA
2017, Journal of the American Medical Directors AssociationRapid Geriatric Assessment: Secondary Prevention to Stop Age-Associated Disability
2017, Clinics in Geriatric MedicineCitation Excerpt :The RGA computer-assisted management system not only recommends the exercise and nutrition program but if the person answers positive for fatigue suggests that person be investigated for sleep apnea,37 hypotension including postural hypotension,38 depression,39 hypothyroidism,40 vitamin B12 deficiency,41 and anemia.42 The health professional is prompted to consider polypharmacy as a cause if the person has more than 5 illnesses,43–46 with an emphasis on medications that are inappropriate for older persons.38 If the person has weight loss, the physician is asked to check for reversible causes using the MEALS-ON-WHEELS mnemonic47,48:
Nutrition and Aging Successfully
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