• Eline E C M Elsten, Iris E Pot, GeijtemanEric C TECTDepartment of Medical Oncology (E.E.C.M.E., I.E.P., E.C.T.G., C.C.D.V.D.R.), Erasmus Medical Center, Cancer Institute Rotterdam, Netherlands., Christel Hedman, Agnes van der Heide, van der KuyP Hugo MPHMDepartment of Hospital Pharmacy (H.V.D.K.), Erasmus Medical Center, Rotterdam, Netherlands., Carl-Johan Fürst, Steffen Eychmüller, Lia van Zuylen, and van der RijtCarin C DCCDDepartment of Medical Oncology (E.E.C.M.E., I.E.P., E.C.T.G., C.C.D.V.D.R.), Erasmus Medical Center, Cancer Institute Rotterdam, Netherlands..
• Department of Medical Oncology (E.E.C.M.E., I.E.P., E.C.T.G., C.C.D.V.D.R.), Erasmus Medical Center, Cancer Institute Rotterdam, Netherlands; Department of Public Health (E.E.C.M.E., A.V.D.H.), Erasmus Medical Center, University Medical Center Rotterdam, Netherlands.
• J Pain Symptom Manage. 2024 Nov 1; 68 (5): 443455.e2443-455.e2.

ContextMedications may become inappropriate for patients in the last phase of life and may even compromise their quality of life.ObjectiveTo find consensus on recommendations regarding deprescribing of medications for adult patients with a life expectancy of six months or less.MethodsExperts working in palliative care or other relevant disciplines were asked to participate in this international Delphi study. Existing tools for deprescribing of medication in the last phase of life were integrated in a list of 42 recommendations regarding potential deprescription of various medication types. In two Delphi rounds, experts were asked to rate their agreement with each recommendation on a 5-point Likert-scale (strongly agree-strongly disagree). Recommendations were accepted, if at least 70% of the experts (strongly) agreed, the interquartile range (IQR) was one or less, and less than 10% strongly disagreed.ResultsAbout 47 experts from 10 countries participated (response rate 53%). In most cases (76%), consensus was reached on deprescribing recommendations for patients with a life expectancy of six months or less. The highest level of consensus was reached for recommendations on the deprescription of diuretics in case of decreasing fluid intake or increasing fluid loss, lipid modifying agents if prescribed for primary prevention, and vitamin K antagonists and direct oral anticoagulants in case of high bleeding risk.ConclusionA high level of consensus was reached on recommendations on potential deprescription of several medications for patients with a life expectancy of six months or less.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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