COVID-SAFER: Deprescribing Guidance for Hydroxychloroquine Drug Interactions in Older Adults.
Identifieur interne : 001613 ( Main/Corpus ); précédent : 001612; suivant : 001614COVID-SAFER: Deprescribing Guidance for Hydroxychloroquine Drug Interactions in Older Adults.
Auteurs : Sydney B. Ross ; Marnie Goodwin Wilson ; Louise Papillon-Ferland ; Sarah Elsayed ; Peter E. Wu ; Kiran Battu ; Sandra Porter ; Babak Rashidi ; Robyn Tamblyn ; Louise Pilote ; James Downar ; Andre Bonnici ; Allen Huang ; Todd C. Lee ; Emily G. McdonaldSource :
- Journal of the American Geriatrics Society [ 1532-5415 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (MeSH), COVID-19 (MeSH), Clinical Trials as Topic (MeSH), Coronavirus Infections (drug therapy), Deprescriptions (MeSH), Female (MeSH), Humans (MeSH), Hydroxychloroquine (administration & dosage), Male (MeSH), Pandemics (MeSH), Patient Selection (MeSH), Pilot Projects (MeSH), Pneumonia, Viral (drug therapy), Polypharmacy (MeSH), Potentially Inappropriate Medication List (standards), SARS-CoV-2 (MeSH).
- MESH :
- chemical , administration & dosage : Hydroxychloroquine.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- standards : Potentially Inappropriate Medication List.
- Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Clinical Trials as Topic, Deprescriptions, Female, Humans, Male, Pandemics, Patient Selection, Pilot Projects, Polypharmacy, SARS-CoV-2.
Abstract
BACKGROUND/OBJECTIVES
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes high morbidity and mortality in older adults with chronic illnesses. Several trials are currently underway evaluating the antimalarial drug hydroxychloroquine as a potential treatment for acute infection. However, polypharmacy predisposes patients to increased risk of drug-drug interactions with hydroxychloroquine and may render many in this population ineligible to participate in trials. We aimed to quantify the degree of polypharmacy and burden of potentially inappropriate medications (PIMs) that older hospitalized adults are taking that would interact with hydroxychloroquine.
METHODS
We reanalyzed data from the cohort of patients 65 years and older enrolled in the MedSafer pilot study. We first identified patients taking medications with potentially harmful drug-drug interactions with hydroxychloroquine that might exclude them from participation in a typical 2019 coronavirus disease (COVID-19) therapeutic trial. Next, we identified medications that were flagged by MedSafer as potentially inappropriate and crafted guidance around medication management if contemplating the use of hydroxychloroquine.
RESULTS
The cohort contained a total of 1,001 unique patients with complete data on their home medications at admission. Of these 1,001 patients, 590 (58.9%) were receiving one or more home medications that could potentially interact with hydroxychloroquine, and of these, 255 (43.2%) were flagged as potentially inappropriate by the MedSafer tool. Common classes of PIMs observed were antipsychotics, cardiac medications, and antidiabetic agents.
CONCLUSION
The COVID-19 pandemic highlights the importance of medication optimization and deprescribing PIMs in older adults. By acting now to reduce polypharmacy and use of PIMs, we can better prepare this vulnerable population for inclusion in trials and, if substantiated, pharmacologic treatment or prevention of COVID-19. J Am Geriatr Soc 68:1636-1646, 2020.
DOI: 10.1111/jgs.16623
PubMed: 32441771
PubMed Central: PMC7280600
Links to Exploration step
pubmed:32441771Le document en format XML
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Ross</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Marnie Goodwin" sort="Wilson, Marnie Goodwin" uniqKey="Wilson M" first="Marnie Goodwin" last="Wilson">Marnie Goodwin Wilson</name><affiliation><nlm:affiliation>Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Papillon Ferland, Louise" sort="Papillon Ferland, Louise" uniqKey="Papillon Ferland L" first="Louise" last="Papillon-Ferland">Louise Papillon-Ferland</name><affiliation><nlm:affiliation>Department of Pharmacy, Institut Universitaire de Gériatrie de Montreal, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Elsayed, Sarah" sort="Elsayed, Sarah" uniqKey="Elsayed S" first="Sarah" last="Elsayed">Sarah Elsayed</name><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wu, Peter E" sort="Wu, Peter E" uniqKey="Wu P" first="Peter E" last="Wu">Peter E. 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Lee</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcdonald, Emily G" sort="Mcdonald, Emily G" uniqKey="Mcdonald E" first="Emily G" last="Mcdonald">Emily G. Mcdonald</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32441771</idno><idno type="pmid">32441771</idno><idno type="doi">10.1111/jgs.16623</idno><idno type="pmc">PMC7280600</idno><idno type="wicri:Area/Main/Corpus">001613</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001613</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-SAFER: Deprescribing Guidance for Hydroxychloroquine Drug Interactions in Older Adults.</title><author><name sortKey="Ross, Sydney B" sort="Ross, Sydney B" uniqKey="Ross S" first="Sydney B" last="Ross">Sydney B. Ross</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wilson, Marnie Goodwin" sort="Wilson, Marnie Goodwin" uniqKey="Wilson M" first="Marnie Goodwin" last="Wilson">Marnie Goodwin Wilson</name><affiliation><nlm:affiliation>Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Papillon Ferland, Louise" sort="Papillon Ferland, Louise" uniqKey="Papillon Ferland L" first="Louise" last="Papillon-Ferland">Louise Papillon-Ferland</name><affiliation><nlm:affiliation>Department of Pharmacy, Institut Universitaire de Gériatrie de Montreal, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Elsayed, Sarah" sort="Elsayed, Sarah" uniqKey="Elsayed S" first="Sarah" last="Elsayed">Sarah Elsayed</name><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wu, Peter E" sort="Wu, Peter E" uniqKey="Wu P" first="Peter E" last="Wu">Peter E. Wu</name><affiliation><nlm:affiliation>Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Battu, Kiran" sort="Battu, Kiran" uniqKey="Battu K" first="Kiran" last="Battu">Kiran Battu</name><affiliation><nlm:affiliation>Department of Pharmacy, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Porter, Sandra" sort="Porter, Sandra" uniqKey="Porter S" first="Sandra" last="Porter">Sandra Porter</name><affiliation><nlm:affiliation>Department of Pharmacy, University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rashidi, Babak" sort="Rashidi, Babak" uniqKey="Rashidi B" first="Babak" last="Rashidi">Babak Rashidi</name><affiliation><nlm:affiliation>Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Tamblyn, Robyn" sort="Tamblyn, Robyn" uniqKey="Tamblyn R" first="Robyn" last="Tamblyn">Robyn Tamblyn</name><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Pilote, Louise" sort="Pilote, Louise" uniqKey="Pilote L" first="Louise" last="Pilote">Louise Pilote</name><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Downar, James" sort="Downar, James" uniqKey="Downar J" first="James" last="Downar">James Downar</name><affiliation><nlm:affiliation>Division of Palliative Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Bonnici, Andre" sort="Bonnici, Andre" uniqKey="Bonnici A" first="Andre" last="Bonnici">Andre Bonnici</name><affiliation><nlm:affiliation>Department of Pharmacy, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Allen" sort="Huang, Allen" uniqKey="Huang A" first="Allen" last="Huang">Allen Huang</name><affiliation><nlm:affiliation>Division of Geriatric Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Todd C" sort="Lee, Todd C" uniqKey="Lee T" first="Todd C" last="Lee">Todd C. Lee</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcdonald, Emily G" sort="Mcdonald, Emily G" uniqKey="Mcdonald E" first="Emily G" last="Mcdonald">Emily G. Mcdonald</name><affiliation><nlm:affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of the American Geriatrics Society</title><idno type="eISSN">1532-5415</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Clinical Trials as Topic (MeSH)</term><term>Coronavirus Infections (drug therapy)</term><term>Deprescriptions (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Male (MeSH)</term><term>Pandemics (MeSH)</term><term>Patient Selection (MeSH)</term><term>Pilot Projects (MeSH)</term><term>Pneumonia, Viral (drug therapy)</term><term>Polypharmacy (MeSH)</term><term>Potentially Inappropriate Medication List (standards)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Potentially Inappropriate Medication List</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Betacoronavirus</term><term>COVID-19</term><term>Clinical Trials as Topic</term><term>Deprescriptions</term><term>Female</term><term>Humans</term><term>Male</term><term>Pandemics</term><term>Patient Selection</term><term>Pilot Projects</term><term>Polypharmacy</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND/OBJECTIVES</b></p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes high morbidity and mortality in older adults with chronic illnesses. Several trials are currently underway evaluating the antimalarial drug hydroxychloroquine as a potential treatment for acute infection. However, polypharmacy predisposes patients to increased risk of drug-drug interactions with hydroxychloroquine and may render many in this population ineligible to participate in trials. We aimed to quantify the degree of polypharmacy and burden of potentially inappropriate medications (PIMs) that older hospitalized adults are taking that would interact with hydroxychloroquine.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We reanalyzed data from the cohort of patients 65 years and older enrolled in the MedSafer pilot study. We first identified patients taking medications with potentially harmful drug-drug interactions with hydroxychloroquine that might exclude them from participation in a typical 2019 coronavirus disease (COVID-19) therapeutic trial. Next, we identified medications that were flagged by MedSafer as potentially inappropriate and crafted guidance around medication management if contemplating the use of hydroxychloroquine.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The cohort contained a total of 1,001 unique patients with complete data on their home medications at admission. Of these 1,001 patients, 590 (58.9%) were receiving one or more home medications that could potentially interact with hydroxychloroquine, and of these, 255 (43.2%) were flagged as potentially inappropriate by the MedSafer tool. Common classes of PIMs observed were antipsychotics, cardiac medications, and antidiabetic agents.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The COVID-19 pandemic highlights the importance of medication optimization and deprescribing PIMs in older adults. By acting now to reduce polypharmacy and use of PIMs, we can better prepare this vulnerable population for inclusion in trials and, if substantiated, pharmacologic treatment or prevention of COVID-19. J Am Geriatr Soc 68:1636-1646, 2020.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32441771</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>31</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>15</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-5415</ISSN><JournalIssue CitedMedium="Internet"><Volume>68</Volume><Issue>8</Issue><PubDate><Year>2020</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Journal of the American Geriatrics Society</Title><ISOAbbreviation>J Am Geriatr Soc</ISOAbbreviation></Journal><ArticleTitle>COVID-SAFER: Deprescribing Guidance for Hydroxychloroquine Drug Interactions in Older Adults.</ArticleTitle><Pagination><MedlinePgn>1636-1646</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/jgs.16623</ELocationID><Abstract><AbstractText Label="BACKGROUND/OBJECTIVES" NlmCategory="OBJECTIVE">Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes high morbidity and mortality in older adults with chronic illnesses. Several trials are currently underway evaluating the antimalarial drug hydroxychloroquine as a potential treatment for acute infection. However, polypharmacy predisposes patients to increased risk of drug-drug interactions with hydroxychloroquine and may render many in this population ineligible to participate in trials. We aimed to quantify the degree of polypharmacy and burden of potentially inappropriate medications (PIMs) that older hospitalized adults are taking that would interact with hydroxychloroquine.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We reanalyzed data from the cohort of patients 65 years and older enrolled in the MedSafer pilot study. We first identified patients taking medications with potentially harmful drug-drug interactions with hydroxychloroquine that might exclude them from participation in a typical 2019 coronavirus disease (COVID-19) therapeutic trial. Next, we identified medications that were flagged by MedSafer as potentially inappropriate and crafted guidance around medication management if contemplating the use of hydroxychloroquine.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The cohort contained a total of 1,001 unique patients with complete data on their home medications at admission. Of these 1,001 patients, 590 (58.9%) were receiving one or more home medications that could potentially interact with hydroxychloroquine, and of these, 255 (43.2%) were flagged as potentially inappropriate by the MedSafer tool. Common classes of PIMs observed were antipsychotics, cardiac medications, and antidiabetic agents.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The COVID-19 pandemic highlights the importance of medication optimization and deprescribing PIMs in older adults. By acting now to reduce polypharmacy and use of PIMs, we can better prepare this vulnerable population for inclusion in trials and, if substantiated, pharmacologic treatment or prevention of COVID-19. J Am Geriatr Soc 68:1636-1646, 2020.</AbstractText><CopyrightInformation>© 2020 The American Geriatrics Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ross</LastName><ForeName>Sydney B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilson</LastName><ForeName>Marnie Goodwin</ForeName><Initials>MG</Initials><AffiliationInfo><Affiliation>Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Papillon-Ferland</LastName><ForeName>Louise</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Pharmacy, Institut Universitaire de Gériatrie de Montreal, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Elsayed</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wu</LastName><ForeName>Peter E</ForeName><Initials>PE</Initials><AffiliationInfo><Affiliation>Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Battu</LastName><ForeName>Kiran</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Pharmacy, University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Porter</LastName><ForeName>Sandra</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Pharmacy, University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rashidi</LastName><ForeName>Babak</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tamblyn</LastName><ForeName>Robyn</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pilote</LastName><ForeName>Louise</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Downar</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Palliative Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bonnici</LastName><ForeName>Andre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Pharmacy, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Allen</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Geriatric Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Todd C</ForeName><Initials>TC</Initials><AffiliationInfo><Affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McDonald</LastName><ForeName>Emily G</ForeName><Initials>EG</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-0783-0624</Identifier><AffiliationInfo><Affiliation>Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Clinical Practice Assessment Unit, McGill University Health Centre, Montreal, Quebec, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R24 AG064025</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><Agency>Fonds de recherche du Québec - Santé</Agency><Country></Country></Grant><Grant><Agency>Centre for Aging and Brain Health Innovation</Agency><Country></Country></Grant><Grant><Agency>Canadian Frailty Network</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Am Geriatr Soc</MedlineTA><NlmUniqueID>7503062</NlmUniqueID><ISSNLinking>0002-8614</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002986" MajorTopicYN="N">Clinical Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000069340" MajorTopicYN="Y">Deprescriptions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018579" MajorTopicYN="N">Patient Selection</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019338" MajorTopicYN="N">Polypharmacy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000067561" MajorTopicYN="N">Potentially Inappropriate Medication List</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">deprescribing</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">polypharmacy</Keyword><Keyword MajorTopicYN="N">potentially inappropriate medications</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32441771</ArticleId><ArticleId IdType="doi">10.1111/jgs.16623</ArticleId><ArticleId IdType="pmc">PMC7280600</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>World Health Organization. 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