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Deprescribing
''Deprescribing'' refers to the reduction in dose and/or stopping of medication that may be causing harm, may no longer be providing benefit, or may be considered inappropriate.〔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 DOI: 10.1111/bcp.12732〕〔Thompson W, Farrell B. Deprescribing: what is it and what does the evidence tell us? Can J Hosp Pharm. 2013 May-Jun; 66(3): 201–202.〕 The process of deprescribing should be planned and supervised by health care professionals. The goal of deprescribing is to reduce medication burden and harm, while maintaining or improving quality of life. It is often applied for those with chronic conditions, for the elderly and for those who have a limited life expectancy.〔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;28:237–253.〕 In all of these situations, certain medications may contribute to an increased risk of adverse events, and people may benefit from a reduction in medication use.
The term ''inappropriate medication'' designates medications that, for a given patient, present a high risk of adverse events, are no longer required, or have an unfavourable risk:benefit ratio, i.e., potential harm outweighs benefits.
==Why deprescribe?==
Older people are the heaviest users of medications, and frequently take five or more medications (polypharmacy). Polypharmacy is associated with increased risks of adverse events, drug interactions, falls, hospitalization, cognitive deficits 〔Cao YJ, et al. Physical and cognitive performance and burden of anticholinergics, sedatives, and ACE inhibitors in older women. Clin Pharmacol Ther 2008;83:422-429〕 and mortality.〔Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007;5(4):345-351〕 Thus, optimizing medication through targeted deprescribing is a vital part of managing chronic conditions, avoiding adverse effects and improving outcomes.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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