A framework and tools for encouraging discussions about deprescribing
Older adults living in long-term care (LTC) homes often take many medications each day – sometimes this is not necessary and can even be harmful. Deprescribing is the planned and supervised process of reducing doses or stopping medications.
Decisions about medications for residents are best made when people work together with their health-care providers. Everyone in an LTC resident’s care team can help make medication-related care safe and effective.
The Bruyère Deprescribing Research Team worked with stakeholders across Ontario’s LTC sector to identify four behaviours and develop supporting tools that help deprescribing become a part of the culture of care. Click on the links in each behaviour to access tools such as process guides, infographics, cue cards and videos:
- People living in LTC homes and their families/caregivers will participate in shared decision-making to establish and monitor goals of care with respect to medication use while taking into consideration effectiveness, safety and non-drug alternatives.
- All healthcare providers and personnel will observe for signs and symptoms in the people they care for and report changes as a result of medication adjustments, or changes that might prompt a deprescribing review.
- Prescribers in every health care setting will document reasons for use, goals and timelines for each medication.
- All members of the health care team will participate in conversations about deprescribing.
Additional resources and tools for optimizing medication use in older adults
- Five evidence-based guidelines that help health care providers make informed assessments of a resident’s medication and explore possibilities for non-drug treatments.
- “Talking about Medications” workshops that can be offered to residents, caregivers and staff to help people have discussions about medication decisions. “Talking About Medications” Materials – Deprescribing.org
- The Canadian Deprescribing Network raises public awareness about deprescribing and provides resources to address safe drug and non-drug approaches. Do I still need this medication? Is deprescribing for you? (deprescribingnetwork.ca)
Deprescribing.org houses deprescribing guidelines and other resources developed by Dr. Barbara Farrell and Dr. Lisa McCarthy’s research team at the Bruyere Research Institute (Ottawa). Barbara and Lisa are pharmacists who work with older people and are concerned about the risks associated with medications in this population.
To learn more about their work visit deprescribing.org.