Talking Points on Deprescribing In Hospice Care

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

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.

• 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.

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.