key: cord-0706152-9sz64w7w
authors: Castelli, Letizia; Loreti, Claudia; Coraci, Daniele; Fusco, Augusto; Biscotti, Lorenzo; Giovannini, Silvia; Padua, Luca
title: Deprescribing in older adults during COVID-19 pandemic, opportunity or risk?
date: 2020-12-01
journal: Res Social Adm Pharm
DOI: 10.1016/j.sapharm.2020.11.016
sha: 3c92c0e2945d4f6451259654177d5e62ff6cff76
doc_id: 706152
cord_uid: 9sz64w7w

nan

Dear Editor,

We have read with pleasure and attention the article "Barriers to conducting deprescribing in the elderly population amid the COVID-19 pandemic" by Elbeddini and colleagues recently published in Research in Social and Administrative Pharmacy. 1 In this very interesting and topical research, the authors analyzed deprescribing barriers, especially in elderly population, prior and linked to SARS-Cov2 infection.

Elderly patients are at a higher risk of recurrent hospitalizations, with consequent complications, such as SARS-CoV-2 (COVID-19) infection. Polypharmacy is associated with several adverse outcomes, including hospitalization, length of hospital stay, and mortality. 2 The COVID-19 pandemic underscores the relevance of continuous prescriber education and development of research studies on deprescribing. 1 In a previous study 3 we documented that polypharmacy (5-9 drugs), and excessive polypharmacy (≥10 drugs) are common among home care patients and that factors associated with polypharmacy status include not only co-morbidity but also specific symptoms and age. 4 Moreover, a study recently reported 3 that drugs are commonly involved in the determination of geriatric syndromes (e.g. falls, delirium, and urinary incontinence), common in nursing home residents and home care clients, by a mechanism of "drug-geriatric syndrome interaction" which occurs when a drug prescribed to treat one condition subsequently exacerbates coexisting chronic conditions. 5 In this perspective, having evidence-based deprescribing guidelines for frail older adults could be very useful. 1 As such, it would be clinically relevant and interesting for medical research knowing the complete drug therapy that patients in the study population are taking. In fact, angiotensin converting enzyme (ACE) inhibitors have demonstrated to protect against cardiovascular events and reduce the incidence of type II diabetes, 6 to have several potential beneficial effects 7 in older adults with high cardiovascular risk profile and to have positive effects on skeletal muscle even in late-life. 8 This is particularly relevant considering that more critical patients affected by SARS-CoV-2 infection are often affected by comorbidities such as diabetes, hypertension and cardiovascular diseases. 1 J o u r n a l P r e -p r o o f

Barriers to conducting deprescribing in the elderly population amid the COVID-19 pandemic

Combined Effects of Frailty and Polypharmacy on Health Outcomes in Older Adults: Frailty Outweighs Polypharmacy

Polypharmacy in Home Care in Europe: Cross-Sectional Data from the IBenC Study

Association of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study

Interactions between drugs and geriatric syndromes in nursing home and home care: results from Shelter and IBenC projects

The authors disclose no financial and personal relationships with other people or organizations that could inappropriately influence their work.J o u r n a l P r e -p r o o f