Talking Points on Deprescribing in Hospice Care

Deprescribing practice in hospice medicine has expanded exponentially in recent years. This book systematically addresses the groups of extremely useful medications to manage chronic disease conditions and prevent complications. It highlights the positive intervention of reducing polypharmacy, improving a terminally ill patient's quality of life, providing individual patient context and helping clinicians in deprescribing. It discusses good ethics, patient wishes and side effect protocols to discontinue no longer relevant medications, thus improving decision-making with the goal of enhancing the patient's quality of life during the time when it is needed the most. Key Features: Empowers the patient, their families, and the providers to have an open discussion about well-informed decision-making. Equips the hospice and palliative care clinicians to comfortably explain the rationale and the discontinuation process of the unessential medications. Highlights the most important facts in bullets along with a unique feature of providing ready-to-go conversational phrases.

Table of Contents:
Introduction Physiologic changes of terminal illness Fundamentals of deprescribing Deprescribing Statins Deprescribing Benzodiazepines Deprescribing Antipsychotics Deprescribing SSRI and SNRIs Deprescribing Tricyclic Antidepressants Deprescribing Anticholinergic drugs for parkinsonism Deprescribing Anticholinergic drugs for urinary incontinence Deprescribing muscle relaxants Deprescribing long-term Opioids Deprescribing Proton Pump Inhibitors Deprescribing Allopurinol Deprescribing Antihyperglycemics Oral Deprescribing Antihyperglycemics Injectable Deprescribing anti-hypertensives Deprescribing Anticoagulants Deprescribing Cholinesterase inhibitors Deprescribing Glaucoma eye drops Deprescribing Vitamin D and Calcium Deprescribing NSAIDs Deprescribing gabapentin and pregabalin Deprescribing long-acting Beta agonist Deprescribing Vitamins Deprescribing medications in children Deprescribing in Transgender and LGBTQ Cultural competency in deprescribing Chaplain and medical social worker When to restart discontinued medications. Medicolegal aspects of deprescribing

About the Author :
Deepak Shrivastava, MD is a board-certified Hospice Medical Director. In addition, he holds board certifications in Internal Medicine, Sleep Medicine, Pulmonary and Critical Care Medicine and Post-Acute and Long-Term Care. He is an academic and clinical faculty at the Sleep, Critical Care and Pulmonary division. He is a Clinical Professor at the University of California. He is an adjunct Professor of Pharmacy at the University of Pacific, School of Pharmacy. He is the recipient of many academic and service awards including the Medical Director of the Year award (2015) at the American Medical Directors Association. Dr. Shrivastava received his training at the State University of New York, University of California, Davis and Stanford. He is an active researcher with a keen interest in medical education. He is directly involved in health care quality and performance improvement. In addition to his active practice of Pulmonary, Critical Care and Sleep Medicine in an ACGME-accredited teaching program, he has been involved in Medicare Hospice Benefit Program since 1989. He is a member of the National Partnership for Healthcare and Hospice Innovation (NPHI). His areas of interest are clinical nursing and hospice physician education, and performance improvement in hospice care.