Deprescribing long-term medications in frail older people approaching end-of-life

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dc.contributor.advisor O'Mahony, Denis en
dc.contributor.advisor Gallagher, Paul en
dc.contributor.author Curtin, Denis
dc.date.accessioned 2020-09-09T08:34:34Z
dc.date.available 2020-09-09T08:34:34Z
dc.date.issued 2019-10-01
dc.date.submitted 2019-10-01
dc.identifier.citation Curtin, D. 2019. Deprescribing long-term medications in frail older people approaching end-of-life. PhD Thesis, University College Cork. en
dc.identifier.endpage 253 en
dc.identifier.uri http://hdl.handle.net/10468/10490
dc.description.abstract One of the great successes of modern medicine is that it has transformed relatively acute causes of death (i.e. cardiovascular disease, organ failure and some cancers) into chronic diseases. In the developed world, most people will now grow old and, over decades, accumulate various chronic diseases before eventually succumbing to a final illness. Older people in their final years are commonly prescribed multiple medications to manage their chronic diseases. These medications may ameliorate symptoms, prevent future adverse health events and extend life. However, the use of multiple medications is also associated with higher risks of side-effects, adverse drug-interactions, and adherence problems. Furthermore, as older people become increasingly frail, the use of multiple medications may be considered burdensome for them or even futile. For frail older patients taking multiple medications, when does the scale shift from net benefit to net harm? If declining health and death are unavoidable, it follows logically that there must come a point when patients no longer benefit from certain chronic disease therapies. This thesis primarily attempts to address two important questions. Firstly, how can we recognize when older people are approaching end-of-life? For such people, a personalized approach that prioritizes comfort and symptom relief is likely to be more appropriate than the pursuit of strict chronic disease targets. Secondly, when attempting to address a frailer older person’s complex and burdensome medication regimen, how do we separate essential medications from those that are dispensable? en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2019, Denis Curtin. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Deprescribing en
dc.subject Frailty en
dc.subject Polypharmacy en
dc.subject End-of-life en
dc.title Deprescribing long-term medications in frail older people approaching end-of-life en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral en
dc.type.qualificationname PhD - Doctor of Philosophy en
dc.internal.availability Full text not available en
dc.description.version Accepted Version en
dc.contributor.funder Horizon 2020 en
dc.description.status Not peer reviewed en
dc.internal.school Medicine en
dc.internal.conferring Autumn 2020 en
dc.internal.ricu HRB Clinical Research Facility at UCC en
dc.relation.project info:eu-repo/grantAgreement/EC/H2020::RIA/634238/EU/OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly/OPERAM en
dc.availability.bitstream embargoed
dc.check.date 2021-09-09


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© 2019, Denis Curtin. Except where otherwise noted, this item's license is described as © 2019, Denis Curtin.
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