Missed Opportunity to Deprescribe: Docusate for Constipation in Medical Inpatients.

摘要: Abstract Background Hospital admissions provide an opportunity to deprescribe ineffective medications and reduce pill burden. Docusate sodium is a stool softener that frequently prescribed treat constipation despite poor evidence for efficacy, thus providing good target deprescription. The aims of this study were characterize rates use discontinuation docusate among internal medicine inpatients, as well other laxatives. Methods We conducted retrospective observational over 1 year on all patients admitted at 2 urban academic hospitals determine use. also evaluated laxative opioid medication random sample 500 inpatients who received patterns prescription Results Fifteen percent (1169/7581) or more doses docusate. Among our sample, 53% (238/452) before admission, only 13% (31/238) had deprescribed. not receiving 33.2% (71/214) new discharge. Patients opioids no laxatives given monotherapy (28%, 51/185). Conclusions was medical its known ineffectiveness, with low deprescription high numbers prescriptions. common even risk constipation. One third admission discharge, potentially exacerbating polypharmacy. already docusate, 80% it continued indicating significant missed opportunities deprescribing. Given the availability effective alternatives, results suggest quality-improvement initiatives are needed promote evidence-based in hospitalized patients.