Written response: AL/2018/64650 dated 2018-12-24. Signed by: Venturi Sergio
N.d.R.: Sopra il questionario. C’è da chiedersi a cosa serva la deprescrizione se c’è l’appropriatezza. Ogni altro commento è superfluo, basta leggere il questionario. L’Assessore cerca comunque di “aggiusta il tiro” di un questionario per lo meno ambiguo.
The undersigned
Director of the Northern League Group
Given that:
The cessation of drugs deemed no longer necessary for various reasons (deprescribing) is an act inherent in a correct pharmacological therapeutic path that the professional undertakes for a patient.
Deprescribing can be defined as a systematic process of identifying and 'discontinuing' drugs or drug regimens in circumstances where apparent or potential adverse effects outweigh their current and/or potential benefits, taking into account the goals of care, level of functioning, life expectancy, values and preferences of the individual patient.
In the elderly subject, often exposed to an excessive number of drugs, deprescribing would therefore seem to be a clear necessity to bring about significant functional benefits for the patient himself.
Whereas:
In the absence of guidelines and robust evidence, the clinician often has difficulty initiating and managing deprescribing, an act that requires, among other things, the active participation of the patient and/or caregiver.
Learned that:
With a general view of recommending a correct prescribing approach to the elderly to clinical professionals, some Local Health Authorities dedicate resources to the development of information tools that allow to support and promote deprescribing.
Some USL companies have prepared and disseminated paths and algorithms for the deprescribing of categories of drugs deemed, under certain conditions, no longer necessary in the elderly patient.
Given that:
Some General Practitioners (GPs) would have been given a "Questionnaire on Deprescribing in the elderly patient" (ANNEX 1) which contains 9 propositions to which the doctor should indicate how much he agrees or disagrees with the proposal.
Among the sentences present is "I am in favor of deprescribing preventive drugs in my elderly patient when his life expectancy no longer justifies any benefits".
Ask the council to find out:
If the delivery of the questionnaire to the General Practitioners by some Ausl of the Region is confirmed.
What kind of project is in place regarding deprescribing in elderly patients.
What objectives does the Regional Health have in relation to this project.
What kind of result is expected from a questionnaire like the one indicated and what kind of evaluation should arise from the answers in the document.
How many and which documents on deprescribing similar to the one under discussion have been distributed and evaluated over the years.
Daniel Marchetti