title: Discontinuation of unnecessary medications in older adults.
abstract: OBJECTIVE
  Identifying and managing the use of medications that may be discontinued is a daunting task for the health care team, especially for the consultant pharmacist. This article discusses a framework to evaluate the risks and benefits of medications. A case-based approach will be employed to demonstrate the application of evidence-based medicine and the challenges that pharmacists face in attempting to discontinue medications in older adults.
  
  
  METHODS
  Medline and Micromedex were used as resources for primary literature as well as drug information.
  
  
  METHODS
  Studies were identified based on their relevance to the case to demonstrate the importance of applying emerging literature and evidence-based medicine.
  
  
  METHODS
  Guidelines on managing osteoporosis as well as diabetes in older adults were used for this case.
  
  
  RESULTS
  A structured framework was applied to demonstrate considerations when tackling challenging medication regimens.
  
  
  CONCLUSIONS
  Patient-centered, individualized medication regimens need to be developed and updated based on the needs of the patient as well as the wishes of the family and caregivers. This is a dynamic process that benefits from the consultant pharmacist, who understands the complexity of the medications and is essential to addressing the use of unnecessary medications.
authors.affiliation: University of Maryland School of Pharmacy, Baltimore, Maryland 21201, USA. nbrandt@rx.umaryland.edu
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Brandt
authors.forename: Richard G
authors.initials: RG
authors.lastname: Stefanacci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D040561:Assisted Living Facilities; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D019090:Case Management; D003920:Diabetes Mellitus / Q000188:drug therapy; D004358:Drug Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006505:Hepatitis / Q000150:complications; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D017706:Lisinopril / Q000627:therapeutic use; D008136:Longevity; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D010024:Osteoporosis / Q000188:drug therapy; D010166:Palliative Care; D010595:Pharmacists; D057285:Precision Medicine; D019821:Simvastatin / Q000627:therapeutic use
chemical_list: D000897:Anti-Ulcer Agents; D000959:Antihypertensive Agents; D050071:Bone Density Conservation Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D019821:Simvastatin; D017706:Lisinopril; D009853:Omeprazole; D019386:Alendronate