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Achieving Better Outcomes through Deprescribing in Hospice

Description

Polypharmacy is a common issue for patients over the age of 65 that frequently escalates at the end of life when patients are prescribed symptom medications in addition to maintenance medications for chronic disease states. Upon admission to hospice, patients may be taking numerous medications with a considerable portion of questionable benefit at end of life. CMS continues to express concern that a high percentage of medications for patients on the hospice benefit are being billed to Medicare Part D.

Studies demonstrate that discontinuing non-beneficial medications at end of life improves patient comfort and quality of life. Hospice clinicians can make an impact by framing medication discontinuation discussions therapeutically, clarifying that stopping or adjusting meds is done to prevent harm and promote patient well-being. These discussions should take place on admission to hospice, during changes in level of care and/or when a trust relationship is formed.

Objectives:

  • Recognize barriers to deprescribing
  • Identify common classes of medications appropriate for discontinuation in hospice
  • Describe communication tactics for discussing medication discontinuation with patients and family members

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