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Digitalis withdrawal in elderly nursing home patients
Journal of the American Geriatrics Society
|December 1, 1985
Summary
Most elderly nursing home patients with normal sinus rhythm do not require a maintenance dose of digoxin. Discontinuing digoxin in these patients often results in positive outcomes, indicating potential for de-prescribing.
Area of Science:
- Geriatric Medicine
- Cardiology
- Pharmacology
Background:
- Digoxin is commonly prescribed for elderly patients.
- The necessity of maintenance digoxin doses in nursing home residents with normal sinus rhythm is often assumed.
- Evidence supporting its continued use in this specific population is limited.
Purpose of the Study:
- To evaluate the clinical utility of maintenance digoxin therapy in elderly nursing home patients diagnosed with normal sinus rhythm.
- To determine if discontinuing digoxin impacts patient well-being in this demographic.
Main Methods:
- A cohort of 64 nursing home patients was assessed.
- Twenty-six patients were identified as being on digoxin.
- Nineteen patients with normal sinus rhythm had their digoxin withdrawn and were closely monitored for four months.
Main Results:
- Eighteen out of 19 patients (94.7%) who stopped taking digoxin remained well.
- No adverse events were reported in the patients who discontinued the medication.
- This suggests a high tolerance for digoxin withdrawal in this group.
Conclusions:
- Maintenance digoxin doses are likely unnecessary for the majority of elderly nursing home patients with normal sinus rhythm.
- De-prescribing digoxin in this population appears safe and effective.
- Clinical practice should consider reassessing the need for long-term digoxin therapy in similar patients.