Deprescription in Palliative Care

Area of Science:

• Geriatrics
• Palliative Care
• Pharmacology

Background:

• Patients with limited life expectancy often have multiple comorbidities and frailty.
• Polypharmacy is common, with medication lists frequently expanding as health status declines.
• Managing complex medication regimens requires balancing chronic disease treatment with symptom palliation.

Purpose of the Study:

• To review the benefits and drawbacks of deprescribing in individuals with limited life expectancy.
• To explore methods for identifying disease trajectories and selecting medications for discontinuation.
• To examine psychosocial impacts and models for rigorous deprescribing.

Main Methods:

• Literature review of deprescribing in patients with limited life expectancy.
• Analysis of drug discontinuation criteria and psychosocial effects.
• Exploration of disease trajectory assessment and deprescribing models.

Main Results:

• Deprescribing involves weighing the benefits of medications against potential risks in frail patients.
• Identifying appropriate deprescribing candidates requires understanding disease progression and patient goals.
• Psychosocial factors significantly influence the deprescribing process in end-of-life care.

Conclusions:

• Deprescribing is an ongoing process, not a single event, necessitating continuous monitoring.
• Aligning medication regimens with patient goals of care and life expectancy is paramount.
• Integrated pharmacological and non-pharmacological management is vital for this population.