1. Ontwikkeling van een tool
voor medicatiereview bij
palliatieve patiënten
Lies Knippenberg
Laurens Van Muysen
Joke Versmissen
Jolien Wevers
Promotor: prof. dr. J. De Lepeleire
Co-promotor: prof. dr. J. Menten
3. Inhoud
• Inleiding
• Aanpak
o Literatuurstudie
o Eerste toetsing experten
o Medicatietool & bijlage
o Tweede toetsing LOK-groepen
• Toekomstperspectieven
• Conclusie
3/23
4. Inleiding
• Polypathologie & polyfarmacie
o 65-plussers
o Risico’s
o Reeds bestaande tools
• START-STOPP
• BEERS
• Palliatieve patiënten?
“Hoe kunnen artsen worden ondersteund in de verbetering van de zorg
voor palliatieve patiënten, gedefinieerd volgens de PICT, inzake
medicatie-oppuntstelling?”
40-50%
4/23
19. Conclusie
“Hoe kunnen artsen worden ondersteund in de verbetering van
de zorg voor palliatieve patiënten, gedefinieerd volgens de
PICT, inzake medicatie-oppuntstelling?”
19/23
20. Dank
prof. dr. J. De Lepeleire
prof. dr. J. Menten
prof. dr. B. Boland
dr. L. Ceulemans
dr. J. Coppens
dr. G. Huysmans
dr. J. Stulens
dr. K. Van Beek
LOK As
LOK Heusden-Zolder
LOK Maasmechelen
LOK Mechelen
LOK Mortsel
LOK Tildonk
LOK Wuustwezel
20/23
22. Vragen?
“Hoe kunnen artsen worden ondersteund in de verbetering van
de zorg voor palliatieve patiënten, gedefinieerd volgens de
PICT, inzake medicatie-oppuntstelling?”
Literatuur-
studie
1ste
toetsing
experten
2de
toetsing
LOK-
groepen
22/23
23. Referenties
• Todd A, Nazar H, Pearson S, Andrew I, Baker L, Husband A. Inappropriate prescribing in patients accessing specialist palliative day care
services. Int J Clin Pharm 2014;36:535-543.
• Br Med J (GB). This week’s poll [Internet]. (United Kingdom): Br Med J (GB); 2017 [citede 2017 Jun 14]. Available from: www.bmj.com
• Scott I, Nimler S, Reeve E, Potter K, Le Couteur D, Rigby D. Reducing inappropriate polypharmacy, the process of deprescribing. JAMA
Internal Medicine 2015;175(5): 827-834.
• Palidwor G, Andrade M. MLTrends. J. Biomed. Discov. Collab. 2010;5: 1-6.
• [Internet]. [cited 2017 Apr 15]. Available from: https://www.hackensackumgpv.org/wp-content/uploads/2014/02/spoonfull-of-medicines.jpg
• Russell BJ, Rowett D, Abernethy AP, Currow DC. Prescribing for comorbid disease in a palliative population: focus on the use of lipid-lowering
medications. Intern Med J. 2014 Feb;44(2):177-84.
• Tija J, Rothman MR, Kiely DK, Shaffer ML, Holmes HM, Sachs GA, et al. Daily medication use in nursing home residents with advanced
dementia. J Am Geriatr Soc. 2010 May;58(5):880-8.
• Tija J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review.
Drugs Aging. 2013 May;30(5):285-307.
• Todd A, Holmes H, Pearson S, Hughes C, Andrew I, Baker L, Husband A. 'I don't think I'd be frightened if the statins went': a
phenomenological qualitative study exploring medicines use in palliative care patients, carers and healthcare professionals. BMC Palliat Care.
2016 Jan 29;15:13.
• van Nordennen RT, Lavrijsen JC, Vissers KC, Koopmans RT. Decision making about change of medication for comorbid disease at the end of
life: an integrative review. Drugs Aging. 2014 Jul;31(7):501-12.
• Vakantie in België [Internet]. 2010 [cited 2017 Jun 19]. Available from: http://belgie.vakantiebestemming.nu/Vlaanderen.html
• [Internet]. [cited 2017 Apr 15]. Available from: https://cdn.shopify.com/s/files/1/0173/4698/files/11650162.jpg?49772
• [Internet]. [cited 2017 Apr 15]. Available from: http://hhpblog.s3.amazonaws.com/blog/wordpress/wp-content/uploads/2011/11/Elderly-woman-
in-hospital-bed.jpg
• FMT gezondheidszorg (NL). ‘Kwaliteitstoetsing in de palliatieve zorg’ [Internet]. Eindhoven (NL): FMT gezondheidszorg (NL); 2015 Oct 14
[cited 2017 Apr 11]. Available from: http://www.fmtgezondheidszorg.nl/iknl-presenteert-kwaliteitstoetsing-in-de-palliatieve-zorg/
23/23
Editor's Notes
Todd A, Nazar H, Pearson S, Andrew I, Baker L, Husband A. Inappropriate prescribing in patients accessing specialist palliative day care services. Int J Clin Pharm 2014;36:535-543.
Br Med J (GB). This week’s poll [Internet]. (United Kingdom): Br Med J (GB); 2017 [citede 2017 Jun 14]. Available from: www.bmj.com
Scott I, Nimler S, Reeve E, Potter K, Le Couteur D, Rigby D. Reducing inappropriate polypharmacy, the process of deprescribing. JAMA Internal Medicine 2015;175(5): 827-834.
Palidwor G, Andrade M. MLTrends. J. Biomed. Discov. Collab. 2010;5: 1-6.
[Internet]. [cited 2017 Apr 15]. Available from: https://www.hackensackumgpv.org/wp-content/uploads/2014/02/spoonfull-of-medicines.jpg
Russell BJ, Rowett D, Abernethy AP, Currow DC. Prescribing for comorbid disease in a palliative population: focus on the use of lipid-lowering medications. Intern Med J. 2014 Feb;44(2):177-84.
Tija J, Rothman MR, Kiely DK, Shaffer ML, Holmes HM, Sachs GA, et al. Daily medication use in nursing home residents with advanced dementia. J Am Geriatr Soc. 2010 May;58(5):880-8.
Tija J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs Aging. 2013 May;30(5):285-307.
Todd A, Holmes H, Pearson S, Hughes C, Andrew I, Baker L, Husband A. 'I don't think I'd be frightened if the statins went': a phenomenological qualitative study exploring medicines use in palliative care patients, carers and healthcare professionals. BMC Palliat Care. 2016 Jan 29;15:13.
van Nordennen RT, Lavrijsen JC, Vissers KC, Koopmans RT. Decision making about change of medication for comorbid disease at the end of life: an integrative review. Drugs Aging. 2014 Jul;31(7):501-12.
Vakantie in België [Internet]. 2010 [cited 2017 Jun 19]. Available from: http://belgie.vakantiebestemming.nu/Vlaanderen.html
[Internet]. [cited 2017 Apr 15]. Available from: https://cdn.shopify.com/s/files/1/0173/4698/files/11650162.jpg?49772
[Internet]. [cited 2017 Apr 15]. Available from: http://hhpblog.s3.amazonaws.com/blog/wordpress/wp-content/uploads/2011/11/Elderly-woman-in-hospital-bed.jpg
FMT gezondheidszorg (NL). ‘Kwaliteitstoetsing in de palliatieve zorg’ [Internet]. Eindhoven (NL): FMT gezondheidszorg (NL); 2015 Oct 14 [cited 2017 Apr 11]. Available from: http://www.fmtgezondheidszorg.nl/iknl-presenteert-kwaliteitstoetsing-in-de-palliatieve-zorg/