Deprescribing at the End of Life: Jennifer Tjia, Jon Furuno, Simon Mooijaart
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
47 min
3 speakers
8 chapters
transcribed 10 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
Why is deprescribing at the end of life an important focus for clinicians?
This podcast is not see me eligible. If people do want to learn more about see me eligible podcasts, Alex, what do they do?
They can go to JerryPal dot org backslash CME.
And on to the show. Welcome to the Jerry Powell Podcast. This is Eric Guidara. This is Alex Smith. And Alex, we're going to be talking about deprescribing at the end of life. Who do we have with us to talk about this?
Today we have two guests joining us from Europe. We have Jen Chia, who is a geriatrician and palliative care doc and researcher who's at UMass Medical Center, but is currently on a Fulbright scholarship in the Netherlands at Leiden University Medical Center. Jen, welcome to the JerryPout Podcast.
Thanks for having me here.
And we're also delighted to welcome Simon Moyart, who's an internist geriatrician and chair of geriatrics and gerontology at Leiden University in the Netherlands. Simon, welcome to GeriPal. Thanks for having me. And delighted to welcome JJ Faruno, who's an epidemiologist who studies hospice and palliative care and is at Oregon State University. JJ, welcome to Jerry Powell.
Uh good to be here. While I love Oregon, I gotta say I I visited Leiden a year ago and I thought it was one of the prettiest cities I've ever seen in my life. Hundred percent. Oh kept it wrong. If our listeners never visited Leiden, go visit Leiden. It is amazing.
I'm completely biased, but um I agree with you.
You're gonna have a flood of Jerry Powell podcast listeners coming your way.
Okay, but that's not we're not talking about lighter. We're gonna talk about end of life deprescribing. But before we do, we always ask for a song request. Who was a song request for Alex?
Uh I believe that's coming from me. JJ, what'd you pick? I picked uh Broke Down Palace by the Grateful Dead. Why did you pick this song? Uh it's a beautiful song. Uh, I think um, you know, the dead just lost another original member in Bob Weir, uh, not that long ago. Uh so it's been on my mind. I think there's different interpretations of the song, but it gets played a lot at memorial ceremonies and and I think it's just a really beautiful, beautiful piece. So I think it'll kick us off well.
Last question Are you a deadhead? Yes.
Right. Have you been to show ever? Uh, I did never saw the original Dead. I did see uh the other ones and some other uh side projects.
My first concert was Grateful Dead, eighth grade in Ann Arbor. Uh amazing show. There you go. Um and yeah, the uh Bob Weir who just died was a resident in Mill Valley, which is where I'm recording this podcast right now. And uh as was Jerry Garcia and um The Philash, they all lived in this area. So sad talking to people like Lynn Flint, who's been on our podcast frequently, who saw Bobby Weir around town. So yes, a very appropriate song. Thank you for choosing this one, JJ. Here's a little bit.
Fare you well, my honey. Fare you well, my only true one. All the birds that were singing. A flow Except you alone. Gonna leave this. broke down palace on my hands and my knees I will roll, roll, roll. Make myself a bed by the water side in my time, in my time I will roll roll roll. In a bed, in a bed by the water side I will lay my head, listen to the river sing sweet songs to rock my soul.
I can always tell how much Alex likes a song, depending on how long the intro song goes. He likes that song.
Great.
All right, I'm gonna start off with a big question because all of you have focused a lot of energy and interest and academic rigor on this topic of deprescribing at the end of life. Why? Like what got you interested in this? Jen?
The story is when I was a geriatrics fellow at Penn, I got to live around the corner from my partner's very world famous violin teacher who was dying of cancer. And we got to take care of him and help him manage his meds and see how his family was dealing with all these meds that he was taking. And Long story short is that the family was so stressed out about trying to figure out which meds he should take, how to get all of them into him at exactly the right time, say T I D or Q8 hours. And they couldn't tell.
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Chapters
8 chapters
1
Why is deprescribing at the end of life an important focus for clinicians?
0:00–5:43
2
What personal experiences sparked the guests' interest in deprescribing?
5:43–11:41
3
Which medications are most commonly identified as candidates for deprescribing in hospice?
11:41–16:32
4
How prevalent is anticoagulant use in the last month of life and what challenges does it pose?
16:32–20:44
5
Why are clinical trials on deprescribing in end‑of‑life populations so difficult to conduct?
20:44–26:41
6
What frameworks like FRAME and Goal‑Concordant Prescribing help guide deprescribing conversations?
26:41–33:34
7
How can shared decision‑making tools balance benefits and risks of drugs such as antithrombotics?
33:34–40:18
8
What practical steps and take‑aways did the experts recommend for clinicians and families?
40:18–47:49
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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