Using Deprescribing Tools and Resources to Optimize Seniors’ Medication Plans
As people age, their list of medications tends to grow. Two out of three Canadian seniors are on more than five prescription medications, while 40 per cent of Canadians over 85 are taking more than 10. Medications can provide effective care, but some may no longer be necessary and may be causing more harm than good.
Who hasn’t seen an older person with a cup in hand, filled with capsules of different size and color? The person may be able to recite the purpose of each medication; another may quietly grumble, “My doctor told me to take it, so I do.”
The engagement of patients and residents in carefully assessing their medication use is a necessary step to delivering quality care — this is where deprescribing comes in.
What is deprescribing?
Deprescribing is the planned and supervised reduction or cessation of a medication that may be harmful or no longer beneficial. The Bruyère Deprescribing Guidelines Research Team and their international co-investigators have developed evidence-informed resources to assist healthcare professionals, educators, patients, residents and their caregivers. These resources support people in incorporating deprescribing into care plans and foster strong relationships between patients/residents and care providers.
Deprescribing resources contain five algorithms, which physicians, nurse practitioners and other prescribers can use to determine if a specific drug class is still the right choice and how it can be tapered or stopped. Infographics explain the drugs and their purpose in laymen’s terms. Videos provide detailed instructions on how to use the algorithms.
With the support of Ontario Centre for Learning, Research and Innovation in Long-Term Care, the Deprescribing team at Bruyère is collaborating with long-term care (LTC) homes in Ottawa to implement the algorithms into regular care plans for their residents. Some of the initial research engaged LTC homes in the Ottawa area.
Feedback on the effectiveness of the existing tools and approaches from LTC homes will feed into plans for sustainably spreading scaling up deprescribing in the sector. Sustainable deprescribing is about teaching healthcare professionals the importance of deprescribing practices, while teaching patients and residents that it’s okay to ask questions about their medications.
Get started on stopping unnecessary medications in your LTC home
Bilingual resources to support deprescribing plans are available online at deprescribing.org.
Please note that this article first appeared in AdvantAge Ontario’s Action Update in October 2018.