Novel tool for deprescribing in chronic patients with multimorbidity: List of evidence-based deprescribing for chronic patients criteria

Rodríguez-Pérez A, Alfaro-Lara ER, Albiñana-Perez S, Nieto-Martín MD, Díez-Manglano J, Pérez-Guerrero C, Santos-Ramos B. Novel tool for deprescribing in chronic patients with multimorbidity: List of evidence-based deprescribing for chronic patients criteria. Geriatr Gerontol Int. 2017 Nov;17(11):2200-2207. Available at: http://onlinelibrary.wiley.com/doi/10.1111/ggi.13062/abstract

Methods

A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the literature and brainstorming as possible situations for deprescribing. They were also asked to assess the influence of life prognosis in each criterion. A tool was composed of the most appropriate criteria according to the strength of their evidence, usefulness in patients with multimorbidity and applicability in clinical practice.

Results

Out of a total of 100, 27 criteria were selected to be included in the final list. It was named the LESS-CHRON criteria (List of Evidence-baSed depreScribing for CHRONic patients), and was organized by the anatomical group of the Anatomical, Therapeutic, Chemical (ATC) classification system of the drug to be deprescribed. Each criterion contains: drug indication for which it is prescribed, clinical situation that offers an opportunity to deprescribe, clinical variable to be monitored and the minimum time to follow up the patient after deprescribing.

Conclusions

The “LESS-CHRON criteria” are the result of a comprehensive and standardized methodology to identify clinical situations for deprescribing drugs in chronic patients with multimorbidity. Geriatr Gerontol Int 2017; 17: 2200–2207.