Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life

Tjia, Jennifer; Lund, Jennifer L.; Mack, Deborah; Mbrah, Attah; Yuan, Yiyang; Chen, Qiaoxi; Osundolire, Seun; McDermott, Cara L.

dc.contributor.author	Tjia, Jennifer
dc.contributor.author	Lund, Jennifer L.
dc.contributor.author	Mack, Deborah
dc.contributor.author	Mbrah, Attah
dc.contributor.author	Yuan, Yiyang
dc.contributor.author	Chen, Qiaoxi
dc.contributor.author	Osundolire, Seun
dc.contributor.author	McDermott, Cara L.
dc.date	2022-08-11T08:11:02.000
dc.date.accessioned	2022-08-23T17:29:58Z
dc.date.available	2022-08-23T17:29:58Z
dc.date.issued	2021-09-01
dc.date.submitted	2021-12-21
dc.identifier.citation	<p>Tjia J, Lund JL, Mack DS, Mbrah A, Yuan Y, Chen Q, Osundolire S, McDermott CL. Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life. Curr Epidemiol Rep. 2021 Sep;8(3):116-129. doi: 10.1007/s40471-021-00264-7. Epub 2021 Apr 23. PMID: 34722115; PMCID: PMC8553236. <a href="https://doi.org/10.1007/s40471-021-00264-7">Link to article on publisher's site</a></p>
dc.identifier.issn	2196-2995 (Print)
dc.identifier.doi	10.1007/s40471-021-00264-7
dc.identifier.pmid	34722115
dc.identifier.uri	http://hdl.handle.net/20.500.14038/50434
dc.description.abstract	Purpose of Review: To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL). Recent Findings: We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications. Tools such as STOPPFrail, OncPal, and the Unnecessary Drug Use Measure can facilitate deprescribing. Outcome measures vary and selection of measures should align with the operationalized deprescribing definition used by study investigators. Summary: EOL deprescribing considerations include medication appropriateness in the context of patient goals for care, expected benefit from medication given life expectancy, and heightened potential for medication-related harm as death nears. Additional data are needed on how EOL deprescribing impacts patient quality of life, caregiver burden, and out-of-pocket medication-related costs to patients and caregivers. Investigators should design deprescribing studies with this information in mind.
dc.language.iso	en_US
dc.relation	<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=34722115&dopt=Abstract">Link to Article in PubMed</a></p>
dc.rights	Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/
dc.subject	Deprescribing
dc.subject	End of life
dc.subject	Medication appropriateness
dc.subject	Methodological
dc.subject	Methods
dc.subject	Outcome measurement
dc.subject	UMCCTS funding
dc.subject	Epidemiology
dc.subject	Health Services Administration
dc.subject	Health Services Research
dc.subject	Pharmacy and Pharmaceutical Sciences
dc.subject	Translational Medical Research
dc.title	Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life
dc.type	Journal Article
dc.source.journaltitle	Current epidemiology reports
dc.source.volume	8
dc.source.issue	3
dc.identifier.legacyfulltext	https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1266&context=umccts_pubs&unstamped=1
dc.identifier.legacycoverpage	https://escholarship.umassmed.edu/umccts_pubs/256
dc.identifier.contextkey	26928300
refterms.dateFOA	2022-08-23T17:29:58Z
html.description.abstract	<p>Purpose of Review: To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL).</p> <p>Recent Findings: We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications. Tools such as STOPPFrail, OncPal, and the Unnecessary Drug Use Measure can facilitate deprescribing. Outcome measures vary and selection of measures should align with the operationalized deprescribing definition used by study investigators.</p> <p>Summary: EOL deprescribing considerations include medication appropriateness in the context of patient goals for care, expected benefit from medication given life expectancy, and heightened potential for medication-related harm as death nears. Additional data are needed on how EOL deprescribing impacts patient quality of life, caregiver burden, and out-of-pocket medication-related costs to patients and caregivers. Investigators should design deprescribing studies with this information in mind.</p>
dc.identifier.submissionpath	umccts_pubs/256
dc.contributor.department	Graduate School of Biomedical Sciences
dc.contributor.department	Department of Population and Quantitative Health Sciences
dc.source.pages	116-129

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Except where otherwise noted, this item's license is described as Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.