PURPOSE: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing. Responses to the survey questions and participant characteristics were quantified and differences evaluated between geriatricians and geriatricians-in-training and between European regions. RESULTS: The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) were generally willing to deprescribe (98%) and felt confident about deprescribing (85%). Despite differences across European regions, the most commonly reported reasons for deprescribing were functional impairment and occurrence of adverse drug reactions. The most important barriers for deprescribing were patients' unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Perceived risk of adverse drug reactions was highest for psychotropic drugs, nonsteroidal anti-inflammatory drugs, cardiovascular drugs, and opioid analgesics. Only one in four respondents (23% of geriatricians and 37% of geriatricians-in-training) think education in medical school had sufficiently prepared them for deprescribing in clinical practice. They reported that their future deprescribing activities would probably increase with improved information sharing between various prescribers, deprescribing recommendations in guidelines, and increased education and training. Approximately 90% think that a paradigm shift is required for prescribers and patients, increasing focus on the possible benefits of deprescribing (potentially) inappropriate medications. CONCLUSIONS: Based on the outcomes of this survey, we recommend investing in improved inter-professional communication, better education and evidence-based recommendations to improve future patient-centered deprescribing practices.
- Klíčová slova
- Adverse drug effects, Deprescribing, Geriatric medicine, Medication review, Older adults, Online survey,
- MeSH
- depreskripce * MeSH
- geriatři MeSH
- internet MeSH
- lidé MeSH
- nežádoucí účinky léčiv * MeSH
- průzkumy a dotazníky MeSH
- zvyky MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The COVID-19 pandemic has severely affected older adults and brought about unprecedented challenges to geriatricians. We aimed to evaluate the experiences of early career geriatricians (residents or consultants with up to 10 years of experience) throughout Europe using an online survey. We obtained 721 responses. Most of the respondents were females (77.8%) and residents in geriatric medicine (54.6%). The majority (91.4%) were directly involved in the care of patients with COVID-19. The respondents reported moderate levels of anxiety and feelings of being overloaded with work. The anxiety levels were higher in women than in men. Most of the respondents experienced a feeling of a strong restriction on their private lives and a change in their work routine. The residents also reported a moderate disruption in their training and research activities. In conclusion, early career geriatricians experienced a major impact of COVID-19 on their professional and private lives.
- Klíčová slova
- Anxiety, COVID-19, Early career geriatricians, Survey, Training,
- MeSH
- COVID-19 * epidemiologie MeSH
- geriatři výchova MeSH
- geriatrie * MeSH
- lidé MeSH
- pandemie MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Breast cancer is the leading cause of death among women, and its incidence increases with age. The average age at diagnosis is 61 years, and the majority of deaths occurs after the age of 65 years. Optimal approach to elderly women with breast cancer is still a major challenge. Elderly patients with cancer should have at least a brief geriatric assessment to detect potentially treatable problems not always adequately evaluated by the oncologists. Therapeutic nihilism should be avoided and effective treatment provided, unless there are compelling reasons against it. Sharing the care for the patient with geriatricians or primary care physicians trained in geriatrics should be considered for all vulnerable and frail elderly patients.
