Project File: DepEnD
Deprescribing at the EnD of life
PhD student: Gregory Verleysen
Project title: Using big data to strengthen the evidence about effects of prescribing and deprescribing of medications in older people with limited life-expectancy
Background and aim: Generally, nursing home (NH) residents use many medications. Medications are beneficial and needed to treat symptoms and diseases, but some medications have questionable benefits at the end of life. These medications with questionable benefits are suitable for deprescribing. Deprescribing means stopping or tapering a medication.
Up to now, we do not know the effects of changes in medication use (e.g. deprescribing medications with questionable benefits and initiating beneficial medications) at the end of life. In this project, we aim to evaluate these effects on the quality of life of NH residents with limited life-expectancy, using innovative data techniques.
Studies: We address the aim of this project by 4 studies:
(1) a qualitative study to explore the factors that facilitate or hinder deprescribing of medications from physicians’, nurses’ and pharmacists’ point of view,
(2) an interrupted time series study to evaluate the effects of clinical practice deprescribing guidelines on actual changes in medication use,
(3) a prospective cohort study to describe health and medication changes of a cohort of NH residents with limited life-expectancy, and
(4) quasi-experimental matched cohort analyses to measure the effects of changes in medication use on quality of life, morbidity and mortality.
Funding agency: FWO (Fonds voor Wetenschappelijk Onderzoek – Vlaanderen)
Prof dr Joachim Cohen (VUB, End-of-Life Care Research Group)
Prof dr Tinne Dilles (UAntwerp, NuPhaC)
dr Kristel Paque (UAntwerp, NuPhaC)