Palabras clave
Deprescripción
Instrumentos
Cómo citar
Resumen
La bibliografía médica abunda en artículos dirigidos a aportar evidencia a procedimientos diagnósticos y terapéuticos. Entre ellos, consensos en formas de Guias de diversas entidades científicas colaboran a la hora de tomar decisiones médicas. Las guías son de especial utilidad en el caso de que las características clínicas del paciente que motiva esa búsqueda de una recomendación terapéutica fuese similar a las de los estudios clínicos y meta-analisis incluidos en las revisiones. De allí surgirá una prescripción basada en distintos grados de evidencia. Para patologías prevalentes en el campo de la Hemostasia y Trombosis como Fibrilación Auricular (FA) y Tromboembolismo venoso (TEV) existen varias Guías, a veces con ligeras diferencias entre ellas, de índole local e internacional. La similitud de conductas terapéuticas generalmente basada en scores de riesgo de trombosis y de hemorragia y cálculo de beneficio clínico neto (BCN), se pierde cuando esta estimación se hace ardua, llevando más probablemente a la suspensión de la anticoagulación, lo que denominaremos en esta revisión, deprescripción. Esta puede ser transitoria o definitiva por características del paciente que no tienen retorno. Reducir la carga de medicamentos permite mejorar la calidad de vida, disminuir efectos secundarios y costos. Existen escasas Guias de deprescripción en el campo de la anticoagulación y por lo tanto, incertidumbre en la evolución esperable para estos pacientes.
Citas
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