Background The LESS-CHRON criteria is a new creation of a list of 27 items to guide deprescribing. It is the result of a literature review followed by DELPHI methodology. Each item consists of: drug and its indication, deprescribing condition, health variable to monitor after deprescribing and period of follow-up.
Purpose To analyse the utility of a new tool to guide deprescribing in patients with chronic pathologies.
Material and methods A chart review was developed by a pharmacist in July 2015. Consent was requested to the service for clinical documentation and statistics from the hospital.
Inclusion criteria for patient analysis were: 80 years of age or older, having a summary discharge from the internal medicine unit between September 2014 and May 2015, suffering from a pathology of the ones considered as indications of possible drugs to deprescribe, presenting active prescriptions of drugs in the sanitary card and alive at the time of the study.
LESS-CHRON criteria were applied using information from the patient´s chart. Data collected were: age, sex and number of active drugs. Data analysed were: number of items of the tool it was possible to apply in the sample, drugs more frequently considered options to deprescribe, as well as items applied for patients.
Results Firstly, 623 patients were obtained from the search but only 50 were included. Reasons for exclusion were: death, absence of active medications or not having enough information to complete the study.
There were 20 men (age average 86 years). Median number of active prescriptions of drugs was 10 (1–25). 18 (67%) items were possible to apply in the sample. The drugs more frequently considered options to deprescribe were: antihypertensives (50% of patients), benzodiazepines and zolpidem/zaleplon for insomnia (30%), benzodiazepines for anxiety (28%) and alpha-adrenergic blockers for benign prostatic hypertrophy (22%).
The median number of items applied for patients was 2. There were 8 patients with no item to apply. The maximum number of items possible to apply in a patient were 5.
Conclusion LESS-CHRON criteria are a useful tool to guide deprescribing in older and chronic patients. Drugs most frequently deprescribed agree with the literature.1,2 It is necessary to validate this result in a clinical trial.
References and/or Acknowledgements
Iyer S, et al. Drugs Aging 2008;25:1021-31
Ostini R, et al. Med Care 2011;49:28-36
References and/or AcknowledgementsNo conflict of interest.
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