M. Stuhec, Slovenia

University of Maribor, Medical Faculty Clinical Pharmacy & Pharmacology
Dr. Matej Stuhec is a professor (Ass.) of both clinical pharmacy and pharmacology, and clinical pharmacist in Slovenia with a strong interest in the pharmacological management of mood disorders, particularly in psychopharmacology, inappropriate prescribing, irrational polypharmacy, antibiotics, and deprescribing. He has additional expertise in the field of pharmacoepidemiology and pharmacokinetics, particularly as it applies to potential drug interactions and medical errors, and conducting epidemiological research relating to psychotropic medications and especially ADHD. He is a Secretary of Section of Psychopharmacology at European Psychiatric Association (EPA) and speaker at many international psychiatric congresses (EPA Nice, Warsaw, Madrid) and congresses supported by the World Psychiatric Association. He is a teacher at three different Slovenian Universities (Medical Faculty Maribor, Faculty of Pharmacy Ljubljana, Sigmund Freud Ljubljana), where he teaches clinical pharmacy, psychopharmacology, and evidence-based medicine. He works also in practice in a psychiatric hospital and primary care setting as a psychiatric clinical pharmacist in Slovenia. He has published more than 50 scientific papers as the first or corresponding author and reviewed more than 120 manuscripts including Lancet, Lancet Psychiatry, European Psychiatry, etc..

Moderator Of 1 Session

Clinical/Therapeutic
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Session Description
The Live Q&A of this session will take place in the Live Sessions auditorium. Please refer to the interactive programme for the exact time and channel.

Proposed by the EPA sections on Psychopharmacology and Old Age Psychiatry-According to the data, more than 50% of elderly patients with mental disorders are treated with multiple drugs (e.g. 5 or more medications), which can lead to medically unnecessary polypharmacy (i.e., irrational polypharmacy). Due to frequent comorbidities and treatments in the elderly, polypharmacy is the rule rather than the exception and can lead to several harms, treatment failures, and inappropriate prescribing. Elderly patients on polypharmacy (rational and irrational) are also excluded from many clinical trials and consequently, this age group is underrepresented in meta-analyses and clinical guidelines as well, which leads to a lack of evidence-based medicine supported results useful for daily practice. In this context, the prudent deprescribing process is a key step in irrational polypharmacy reduction. The purpose of deprescribing is to reduce inappropriate polypharmacy, medication burden and harm, and to improve patient health-related outcomes. There are some tools available that can help in the deprescribing process in clinical practice, including different medication lists (e.g. Beers criteria, STOPP/START, and guidelines). This proposed joint workshop of the Section of Old Age Psychiatry and the Section of Psychopharmacology will address a neglected topic: why and when to use the deprescribing process of psychotropics in elderly patients in real clinical settings. Experts in psychiatry and psychopharmacology will specifically address the use of the deprescribing process of antidepressants, antipsychotics, hypnotics, and other psychotropics in this population. The participants will learn why is important to use deprescribing processes supported by evidence-based data and real clinical pharmacological tools useful for daily practice.

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Pre-Recorded with Live Q&A, Section

Presenter Of 4 Presentations

LIVE - Symposium: Psychopharmacology During Infections, Including COVID-19 (ID 302) No Topic Needed

Live Q&A

Session Icon
Live, Section
Date
Sun, 11.04.2021
Session Time
10:00 - 11:30
Room
Channel 3
Lecture Time
11:08 - 11:28
Workshop: Medication Deprescribing in Elderly Patients with Mental Disorders: Why, When, and How? (ID 273) No Topic Needed

Live Q&A

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Lecture Time
11:08 - 11:28
LIVE - Symposium: Psychopharmacology During Infections, Including COVID-19 (ID 302) No Topic Needed

S0024 - The Pharmacotherapy of Infections in Patients with Mental Disorders Receiving Psychotropic Drugs: Focus on Good Practices

Session Icon
Live, Section
Date
Sun, 11.04.2021
Session Time
10:00 - 11:30
Room
Channel 3
Lecture Time
10:51 - 11:08

ABSTRACT

Abstract Body

There is little data on infection treatment in patients with mental disorders, including on the selection of psychotropic, antibiotic, antifungal, and antiviral medications. Bacterial, viral, and fungal infections often occur in patients with mental illnesses, and there is little data on rational pharmacotherapy in this vulnerable population. Antibiotic treatment is a common event during hospitalization in adult psychiatric hospitals and poses a risk of significant potential to almost a quarter of all patients. Most infections are bacterial infections where antibiotics are used, and this topic will be covered in this lecture.
Most patients are being treated for urinary tract infections or respiratory tract infections. The most commonly prescribed antibiotics are co-amoxiclav and cotrimoxazole, followed by ciprofloxacin and nitrofurantoin. Drug-drug interactions (DDIs) between antibiotics and psychotropics often occur, where medications with QTc prolongation potential should be avoided (e.g., some antipsychotics and antidepressants, quinolones, and cotrimoxazole). Penicillins are the most appropriate group, and quinolones should be avoided. DDIs between antibiotics and psychotropic drugs have been reported to occur in 20% of patients, which means that DDIs checking is always necessary before prescribing. Psychiatric adverse events (e.g., hallucinations, restlessness, insomnia) have also been seen in patients with mental disorders.
The participants will learn about general recommendations on antibiotic prescribing in this population, focusing on antibiotics and psychotropics, supported by evidence-based data and real clinical pharmacological tools useful for daily practice.

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Workshop: Medication Deprescribing in Elderly Patients with Mental Disorders: Why, When, and How? (ID 273) No Topic Needed

W0060 - Different General Strategies for Deprescribing in Real Clinical Settings: From Lists to Collaborative Care

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Tue, 13.04.2021
Session Time
10:00 - 11:30
Room
Channel 6
Lecture Time
10:00 - 10:17

ABSTRACT

Abstract Body

Most elderly patients with mental disorders are treated with polypharmacy (e.g., five or more medications), and they are receiving medications that are potentially inappropriate for elderly patients (e.g., PIMs). These aspects are often excluded in the clinical guidelines, meta-analyses, and randomized controlled trials but are very important for prudent prescribing in daily practice. The most robust approach to reducing irrational polypharmacy, PIMs, and other medications-related problems in this population is a careful deprescribing process. It is the process of tapering, withdrawing, discontinuing, or stopping medications. There are some tools available to help in the deprescribing process in clinical practice, including different medication lists (e.g., Beers criteria, STOPP/START, and guidelines) and collaborative care, including clinical pharmacist or pharmacologist. Medication lists have been used in clinical trials and guidelines, where Beers criteria are used predominantly in the U.S. and Priscus list in Europe. A collaborative care approach, including a clinical pharmacist, has been established only in some countries (e.g., USA, UK & Slovenia). The results are positive with a decrease of PIMs, polypharmacy, and an increase in the patients’ quality of life.

The participants will learn the general deprescribing processes supported by the evidence-based data and real clinical pharmacological tools useful for daily practice.

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