Department of Population and Quantitative Health Sciences; Graduate School of Biomedical Sciences
Epidemiology | Health Services Administration | Health Services Research | Pharmacy and Pharmaceutical Sciences | Translational Medical Research
Purpose of Review: To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL).
Recent Findings: We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications. Tools such as STOPPFrail, OncPal, and the Unnecessary Drug Use Measure can facilitate deprescribing. Outcome measures vary and selection of measures should align with the operationalized deprescribing definition used by study investigators.
Summary: EOL deprescribing considerations include medication appropriateness in the context of patient goals for care, expected benefit from medication given life expectancy, and heightened potential for medication-related harm as death nears. Additional data are needed on how EOL deprescribing impacts patient quality of life, caregiver burden, and out-of-pocket medication-related costs to patients and caregivers. Investigators should design deprescribing studies with this information in mind.
Deprescribing, End of life, Medication appropriateness, Methodological, Methods, Outcome measurement, UMCCTS funding
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DOI of Published Version
Tjia J, Lund JL, Mack DS, Mbrah A, Yuan Y, Chen Q, Osundolire S, McDermott CL. Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life. Curr Epidemiol Rep. 2021 Sep;8(3):116-129. doi: 10.1007/s40471-021-00264-7. Epub 2021 Apr 23. PMID: 34722115; PMCID: PMC8553236. Link to article on publisher's site
Current epidemiology reports
Tjia J, Lund JL, Mack D, Mbrah A, Yuan Y, Chen Q, Osundolire S, McDermott CL. (2021). Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life. UMass Center for Clinical and Translational Science Supported Publications. https://doi.org/10.1007/s40471-021-00264-7. Retrieved from https://escholarship.umassmed.edu/umccts_pubs/256
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.