Project summary in plain language

Improving drug therapy for for palliative care patients at the end of life

Deprescribing: Medication management for palliative care patients at the end of life – Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) for German-speaking countries

 

Problem/patient group

Palliative patients often receive several drugs at the end of their lives, both for the treatment of stressful symptoms and for comorbidities. Given the limited life expectancy of palliative care patients, it is important to continually assess whether a medication is still indicated, provides the desired benefit, or should be discontinued. In deprescribing, drugs that are unsuitable, not indicated or no longer useful in the current situation should be controlled tapered or safely discontinued. To date, no validated tool is available in German-speaking countries to support pharmacists and physicians in this processes.

Aim

This study aimed to develop a culturally adapted German version of STOPPFrail (version 2).

Implementation

First, a (1) systematic translation of the English original into German was carried out. Then (2) cognitive interviews were conducted with twelve physicians and pharmacists to assess the comprehensibility and relevance of the individual criteria of the instrument for use in the German-speaking healthcare sector. After each round of interviews with three people, the instrument was modified as required. In the final part (3), doctors and pharmacists independently identified drugs potentially suitable for deprescribing using case vignettes as part of an online survey.

Result

A culturally adapted German version of the STOPPFrail (Version 2) was developed and the level of agreement in its application (interrater reliability) was determined.

Patient benefit

As the first German-language deprescribing tool for palliative care patients at the end of life, STOPPFrail can support the implementation of deprescribing processes in clinical practice. Through targeted and repeated review of the therapeutic regimen, patients receive only those drugs that are appropriate in their current situation. This prevents unnecessary drug burden and reduces the risk of adverse health outcomes.

 

Image source: Sara Michiel