Kidney SCHOLAR Teams: A Collaboration to Improve Palliative Care for New York City Patients with Kidney Disease (SA312A)

Continuingdisease-directed medications for advanced neurologic disease requires careful consideration of risks and benefits.Medications for progressive neurologic disease are often aimed at management of symptoms only.The decision to discontinue medications when the burden outweighs potential benefit can be difficult for clinicians, patients and caregivers.The first section will develop a framework for deprescribing, beginning with making the decision to deprescribe, and then discussing safe discontinuation of medications, potential adverse effects of discontinuation, and the evidence for alternative routes of administration when the oral route is lost.We will conclude with strategies on how to approach guiding patients and caregivers through the process of deprescribing.The next section will be a case-based discussion applying the framework from the first section to cases in Parkinson disease, Alzheimer's dementia, and seizure disorders.Deprescribing is a common scenario encountered in hospice and palliative care as patients near the end of life.This presentation will provide a review of evidence and best practices.Information presented from the unique perspectives of a hospice nurse, pharmacist, and physician will model the interdisciplinary team approach to implementing deprescribing analysis in the care of patients.Recognizing that varied practice patterns exist, we plan to engage the audience in an interactive discussion that will provide actionable tips that can be applied to clinical practice.