Talking Points on Deprescribing in Hospice Care

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.

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