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University of Groningen

Deprescribing in older people

van der Meer, Helene Grietje

IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from

it. Please check the document version below.

Document Version

Publisher's PDF, also known as Version of record

Publication date:

2019

Link to publication in University of Groningen/UMCG research database

Citation for published version (APA):

van der Meer, H. G. (2019). Deprescribing in older people: development and evaluation of complex

healthcare interventions. Rijksuniversiteit Groningen.

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DEPRESCRIBING

D

EP

R

ES

CR

IBIN

G IN OLD

ER P

EO

PLE

IN OLDER PEOPLE

Heleen van der Meer

He

leen v

an der Meer

Development and evaluation of complex

healthcare interventions

Helene Grietje (Heleen) van der Meer was born on 5  August 1990 in Papenburg, Germany, to Wytze Jan van der Meer, dentist, and Klaaske van der Meer- Jansen, cardiac care nurse. She grew up in Germany together with her younger sister and brother. In 2009 she obtained her Abitur (final exam) at the Gymnasium Papenburg and started her studies in pharmacy at the University of Groningen.

Heleen first became acquainted with research in the field of pharmacotherapy during her Bachelors studies. The foundation for her doctoral thesis was laid during the project she undertook in Sydney, Australia under supervision of Dr. Lisa Pont and Prof. Dr. Katja Taxis for her Masters in Pharmacy in 2013/14. On her return to the Netherlands, she accepted a temporary appoint-ment as a researcher with Prof. Taxis and in the same year gave her first podium presentation at an inter-national scientific conference in Boston, US. She was awarded her Masters in Pharmacy in 2016 and com-pleted her PhD in 2018. Heleen lives in The Hague and works as a postdoctoral researcher under supervision of Prof. Taxis on the development and implementation of patient material for deprescribing in older people. In addition to her studies and PhD research, Heleen has been active within various committees. For example, in 2016/17 she organized the PhD Day, a career event for 900 PhD students/postdocs. Furthermore she loves tennis and sailing and she has a passion for traveling.

UITNODIGING

Voor het bijwonen van de

openbare verdediging van

het proefschrift:

DEPRESCRIBING

IN OLDER PEOPLE

Development and

evaluation of complex

healthcare interventions

door

HELEEN VAN DER MEER

op vrijdag

2 november om 16.15

in het Academiegebouw

van de Rijkuniversiteit

Groningen, Broerstraat 5

te Groningen.

Na afloop bent u

van harte uitgenodigd

voor de receptie

in het Academiegebouw.

Heleen van der Meer

Helmersstraat 36

2513 RZ Den Haag

0648897302

h.g.van.der.meer@rug.nl

PARANIMFEN

Karlien Sambell

karliensambell@gmail.com

Linda van Eikenhorst

l.van.eikenhorst@rug.nl

(3)

DEPRESCRIBING

IN OLDER PEOPLE

Heleen van der Meer

Development and evaluation of complex

healthcare interventions

(4)

Deprescribing in older people

Development and evaluation of complex healthcare interventions

Proefschrift

ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen

op gezag van de

rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties.

De openbare verdediging zal plaatsvinden op vrijdag 22 maart 2019 om 16.15 uur

door

Helene Grietje van der Meer

geboren op 5 augustus 1990

te Papenburg, Duitsland

Deprescribing in older people

Development and evaluation of complex healthcare interventions

Proefschrift

ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen

op gezag van de

rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties.

De openbare verdediging zal plaatsvinden op vrijdag 2 november 2018 om 16.15 uur

door

Helene Grietje van der Meer

geboren op 5 augustus 1990 te Papenburg, Duitsland Colophon

The research presented in this thesis was financially supported by the Royal Dutch Pharmacists Association (KNMP) and Stichting Stoffels Hornstra. Cover concept: Heleen van der Meer

Cover and layout design: Lovebird design.

www.lovebird-design.com Printing: Eikon+

ISBN (e-book):   978-94-034-0954-2 ISBN (printed book): 978-94-034-0955-9

Printing of this thesis was financially supported by the Groningen Graduate School of Science and Engineering (GSSE), the University of Groningen and Stichting Koninklijke Nederlandse Maatschappij ter Bevordering der Pharmacie (KNMP) Fondsen, and is gratefully acknowledged.

© Copyright, 2018, Heleen van der Meer

All rights reserved. No part of this publication may be reproduced or transmit-ted in any form or by any means, without written permission of the author.

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CONTENTS

CHAPTER 1

General Introduction And Thesis Outline

7

CHAPTER 2 Changes In Prescribing Symptomatic And

Preventive Medications In The Last Year Of

Life In Older Nursing Home Residents

19

CHAPTER 3 Anticholinergic and sedative medication

use in older community-dwelling people: a

national population study in the Netherlands 43

CHAPTER 4 Decreasing the load? Is a multidisciplinary

multistep medication review in older people

an effective intervention to reduce a patient’s

drug burden index? Protocol of a randomised

controlled trial

63

CHAPTER 5 Reducing the anticholinergic and sedative

load in older patients on polypharmacy

by pharmacist-led medication review: A

randomised controlled trial

81

CHAPTER 6 Feasibility, acceptability and potential

effectiveness of an information technology

based, pharmacist-led intervention to prevent

an increase in anticholinergic and sedative

load among older community-dwelling

individuals. 109

CHAPTER 7 General discussion

137

CHAPTER 8 Summary 151

Samenvatting

157

Acknowledgements — Dankwoord

163

List of publications

169

Promotor Prof. dr. K. Taxis Dr. L.G. Pont Co-promotor Dr. H. Wouters Beoordelingscommissie Prof. dr. P. Denig Prof. dr. M.L. Bouvy

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