title: [Systematic elimination of prescribed medicines is acceptable and feasible among polymorbid family medicine patients].
abstract: Polypharmacy increasingly is a problem in the care of polymorbid and elderly people, and affects morbidity and mortality. We adapted an algorithm for systematic deprescribing of medicaments (Good Palliative Geriatric Practice, developed for geriatric patients originally), and performed a practicability and acceptance study with 14 general practitioners and 63 patients with 523 medicaments totally. By the intervention 13% of all medicaments could be changed and 9% stopped, mostly (56%) due to an absence of indication. 75% of patients given a recommendation to change a medicament agreed. Acceptance and practicability of the tool were rated clearly positive by physicians. To study efficacy a randomized-controlled trial with clinical outcomes, long-term follow up and the exploration of patients' views is warranted.
authors.affiliation: Institut für Hausarztmedizin Zürich, Universität Zürich.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neuner-Jehle
authors.affiliation: Abteilung Klinische Ethik, Universitätsspital Zürich und Universität Zürich.
authors.forename: Tanja
authors.initials: T
authors.lastname: Krones
authors.affiliation: Institut für Hausarztmedizin Zürich, Universität Zürich.
authors.forename: Oliver
authors.initials: O
authors.lastname: Senn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002908:Chronic Disease / Q000628:therapy*; D015897:Comorbidity; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D005194:Family Practice; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D055656:Prescriptions; D013557:Switzerland
keywords: Hausarztmedizin; Medikamentenreduktion; Polypharmazie; deprescribing; effects secondaires; family medicine; gemeinsame Entscheidungsfindung; inappropriate medication; médicine de famille; polypharmacie; polypharmacy; prise de décision partagée; shared decision making; ungeeignete Medikation