Pub Date : 2019-07-01DOI: 10.1093/MED/9780190654818.003.0012
Swapnil Gupta, Rebecca Miller, J. Cahill
This chapter summarizes and emphasizes the key elements of deprescribing, including developing and maintaining a strong therapeutic alliance, open communication, shared decision making, and a tolerance of uncertainty. The chapter also discusses future directions for research, such as receptor neuroimaging to investigate psychotropic withdrawal syndromes and the consolidation of patient narratives of medication discontinuation. Recommendations for integrating deprescribing into clinical practice, such as the development of tools and algorithms, reminders in electronic health records, and the setting up of “deprescribing clinics” or deprescribing consultation services are also discussed. Finally, the authors provide suggestions for the training of medical students, psychiatry residents, and other prescribers in the process of deprescribing.
{"title":"Concluding Thoughts and Future Directions","authors":"Swapnil Gupta, Rebecca Miller, J. Cahill","doi":"10.1093/MED/9780190654818.003.0012","DOIUrl":"https://doi.org/10.1093/MED/9780190654818.003.0012","url":null,"abstract":"This chapter summarizes and emphasizes the key elements of deprescribing, including developing and maintaining a strong therapeutic alliance, open communication, shared decision making, and a tolerance of uncertainty. The chapter also discusses future directions for research, such as receptor neuroimaging to investigate psychotropic withdrawal syndromes and the consolidation of patient narratives of medication discontinuation. Recommendations for integrating deprescribing into clinical practice, such as the development of tools and algorithms, reminders in electronic health records, and the setting up of “deprescribing clinics” or deprescribing consultation services are also discussed. Finally, the authors provide suggestions for the training of medical students, psychiatry residents, and other prescribers in the process of deprescribing.","PeriodicalId":296046,"journal":{"name":"Deprescribing in Psychiatry","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114348288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-05DOI: 10.2174/157340051401180905153413
Swapnil Gupta, J. Cahill, Rebecca Miller
With the growth of polypharmacy across medicine, the concept of deprescribing—reducing or eliminating the use of medication—is gaining traction among prescribers in a range of specialties. Applying this concept to psychiatry is more complex than in other fields of medicine and requires expanding the intervention to include consideration of psychological, social, environmental, and cultural factors. Taking a recovery-oriented and strengths-based approach, this book outlines the need for deprescribing in psychiatry and expands on the intervention to look at barriers and strategies for addressing them, as well as specific considerations for classes of psychotropic medications. The book is explicitly not against the use of medications but instead promotes a rational approach to considering the reduction of medications when indicated and when agreed upon by both prescriber and patient by promoting the use of shared decision-making and working to minimize risk while maximizing quality of life. The book includes learning objectives, self-assessment quizzes, and case examples to support the reader and provide concrete illustrations of implementation. It is geared toward all prescribers of psychiatric medications and is useful as well for patients, family members, and other mental health practitioners interested in learning more about approaches to making the best, most judicious use of psychiatric medications in mental health.
{"title":"Deprescribing in Psychiatry","authors":"Swapnil Gupta, J. Cahill, Rebecca Miller","doi":"10.2174/157340051401180905153413","DOIUrl":"https://doi.org/10.2174/157340051401180905153413","url":null,"abstract":"With the growth of polypharmacy across medicine, the concept of deprescribing—reducing or eliminating the use of medication—is gaining traction among prescribers in a range of specialties. Applying this concept to psychiatry is more complex than in other fields of medicine and requires expanding the intervention to include consideration of psychological, social, environmental, and cultural factors. Taking a recovery-oriented and strengths-based approach, this book outlines the need for deprescribing in psychiatry and expands on the intervention to look at barriers and strategies for addressing them, as well as specific considerations for classes of psychotropic medications. The book is explicitly not against the use of medications but instead promotes a rational approach to considering the reduction of medications when indicated and when agreed upon by both prescriber and patient by promoting the use of shared decision-making and working to minimize risk while maximizing quality of life. The book includes learning objectives, self-assessment quizzes, and case examples to support the reader and provide concrete illustrations of implementation. It is geared toward all prescribers of psychiatric medications and is useful as well for patients, family members, and other mental health practitioners interested in learning more about approaches to making the best, most judicious use of psychiatric medications in mental health.","PeriodicalId":296046,"journal":{"name":"Deprescribing in Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130040519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：