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Drug Therapy

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
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Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
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Team approach to polypharmacy evaluation and reduction: study protocol for a randomized controlled trial.

Dee Mangin1, Larkin Lamarche2, Gina Agarwal2

  • 1Department of Family Medicine, McMaster University, 100 Main Street West., 5th floor, Hamilton, Ontario, L8P 1H6, Canada. mangind@mcmaster.ca.

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Summary
This summary is machine-generated.

This study tested the TAPER pathway to reduce polypharmacy in older adults. The Team Approach to Polypharmacy Evaluation and Reduction (TAPER) pathway aims to decrease medication burden and improve health outcomes.

Keywords:
DeprescribingHealth outcomesMedication reductionMultimorbidityOlder adultsOperationalized clinical modelOvermedicationPhysician pharmacist collaborationPolypharmacy

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Polypharmacy in older adults is linked to adverse outcomes like falls, cognitive decline, and functional impairment.
  • Current primary care lacks systematic approaches to reduce inappropriate polypharmacy, especially those incorporating patient preferences.
  • The reversibility of negative outcomes through medication reduction is not well-established.

Purpose of the Study:

  • To test the effectiveness of the TAPER (Team Approach to Polypharmacy Evaluation and Reduction) pathway in reducing inappropriate polypharmacy.
  • To evaluate the impact of TAPER on the number of medications and associated health-related outcomes in older adults.
  • To assess a structured clinical pathway that integrates medication review, tapering guidance, and patient-centered priorities.

Main Methods:

  • A multi-center randomized controlled trial involving 360 older adults (≥70 years) on five or more medications.
  • Participants were randomized to either the TAPER intervention group or a wait-list control group.
  • The intervention included a multidisciplinary medication review by pharmacists and physicians, focusing on reducing medication burden and incorporating patient goals.

Main Results:

  • The primary outcome is the change in the number of medications.
  • Secondary outcomes include health-related quality of life, cognitive function, and fall rates.
  • Data collection occurred at baseline and 6-month follow-up for both groups.

Conclusions:

  • The TAPER trial introduces a unique, operationalized clinical pathway for polypharmacy reduction in primary care.
  • This approach uniquely combines evidence-based medication management with explicit elicitation of patient priorities and treatment goals.