Low-value Care

Implantable Cardioverter Defibrillator Management at the End of Life

Abstract: This Teachable Moment advocates for considering a patient’s implantable cardioverter defibrillator in discussions regarding a do-not-resuscitate order.

Publication: JAMA Internal Medicine

Date Published: October 26, 2020

Author(s): Samuel A. Kelly, MD, MBE, Ryan Kabir, MD and Neil Keshvani, MD

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To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.