{
  "abstract": "Objective To identify potentially inappropriate medications (PIMs) using deprescribing tools and to evaluate longitudinal changes in the number of PIMs and their associated costs between baseline (T₀) and follow-up (T F) among patients receiving outpatient palliative care (PC).Methods This retrospective longitudinal study reviewed electronic medical records of adult patients (≥18 years) who initiated follow-up in 2022 at an outpatient PC clinic of a Brazilian teaching hospital. Patients were monitored for up to 12 months. PIMs were identified using the STOPPFrail version 2 (v2) and OncPal criteria at baseline (T₀) and at the last outpatient consultation (T F). Differences in the number of PIMs and their associated costs between T₀ and TF were analysed using descriptive statistics and paired comparisons with the Wilcoxon signed-rank test.Results Among 42 patients included in the longitudinal analysis, STOPPFrail v2 identified a small but statistically significant increase in PIM exposure over time (median 3 (IQR 3–4) at T₀ vs 4 (IQR 3–5) at T F; p=0.041). Median PIM-related costs also increased, from US$0.06 (IQR 0.03–0.25) at T₀ to US$0.14 (IQR 0.04–0.26) at TF; however, this difference was not statistically significant (p=0.165). In contrast, according to the OncPal criteria, PIM exposure remained stable (median 4 (IQR 3–5) at both T₀ and TF; p=0.591). Likewise, PIM-related costs showed no significant change, increasing from US$0.05 (IQR 0.01–0.10) at T₀ to US$0.08 (IQR 0.04–0.14) at TF (p=0.117).Conclusions PIM exposure remained high over time in outpatient PC, with minimal variation depending on the assessment tool used and no significant reduction in medication-related costs. These findings highlight the complexity of prescribing in this population and the need for new deprescribing strategies.",
  "authors": [
    {
      "affiliations": [
        "Departament of Pharmaceutical Sciences, University of São Paulo (USP), School of Pharmaceutical Sciences, Ribeirão Preto, Brazil"
      ],
      "name": "Júlia Raso Ferreira De Oliveira"
    },
    {
      "affiliations": [
        "Ciências Farmacêuticas, Universidade de São Paulo Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirao Preto, Brazil"
      ],
      "name": "Bruno Aparecido Cazotti Ramalho"
    },
    {
      "affiliations": [
        "Departament of Pharmaceutical Sciences, University of São Paulo (USP), School of Pharmaceutical Sciences, Ribeirão Preto, Brazil"
      ],
      "name": "Bruno Vieira Felix Da Silva"
    },
    {
      "affiliations": [
        "Departament of Pharmaceutical Sciences, University of São Paulo (USP), Ribeirão Preto, Brazil"
      ],
      "name": "Nátali Voltolini Marinho"
    },
    {
      "affiliations": [
        "Departament of Pharmaceutical Sciences, University of São Paulo (USP), School of Pharmaceutical Sciences, Ribeirão Preto, Brazil"
      ],
      "name": "Marília Silveira De Almeida Campos"
    },
    {
      "affiliations": [
        "Internal Medicine, University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, Brazil"
      ],
      "name": "Nereida Kilza Da Costa Lima"
    },
    {
      "affiliations": [
        "Department of Pharmaceutical Sciences, Universidade de São Paulo Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirao Preto, Brazil"
      ],
      "name": "Leonardo Régis Leira Pereira"
    },
    {
      "affiliations": [
        "Departament of Pharmaceutical Sciences, University of São Paulo (USP), School of Pharmaceutical Sciences, Ribeirão Preto, Brazil"
      ],
      "name": "Maria Olivia Barboza Zanetti"
    },
    {
      "affiliations": [
        "Department of Pharmaceutical Sciences, Universidade de São Paulo Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirao Preto, Brazil"
      ],
      "name": "Fabiana Rossi Varallo"
    }
  ],
  "title": "Potentially inappropriate medications in outpatient palliative care: retrospective longitudinal study of exposure and costs",
  "uid": "042853d8-a5f9-59b4-80d9-610d0b6605bf"
}