Deprescribing involves reviewing and tapering off redundant medications to reduce health risks, a process that experts say should be done in collaboration with a healthcare provider.
Key facts
- •Deprescribing involves reducing total medication counts, lowering doses, or substituting medications with lower-risk alternatives.
- •Health Canada recommends using sleep medicines only as a short-term, two-week intervention.
- •Long-term use of heartburn medications can affect bone health by hindering calcium absorption.
- •Patients are advised to revisit any new medication with their doctor or pharmacist within six months.
- •The Canadian Medication Appropriateness and Deprescribing Network provides resources for both patients and providers.
Dr. Cheryl Sadowski, a pharmacy researcher at the University of Alberta, is advocating for the practice of deprescribing to address the risks of polypharmacy. Deprescribing involves reviewing a patient's medications to identify and taper off those that are no longer beneficial or are causing harm. This approach aims to combat clinical inertia, where patients remain on medications long-term without regular reassessment, potentially leading to adverse effects like falls and confusion.
The Risks of Polypharmacy
Research indicates that in 2021, up to one in four older adults in Canada were taking 10 or more different classes of medication. This level of polypharmacy increases the risk of harmful drug interactions eightfold compared to taking two medications. Dr. Sadowski notes that common side effects like confusion or falls in seniors are often incorrectly attributed to aging when they may be caused by medication.
Medications Often Overprescribed
Sadowski identifies sleeping pills, heartburn medications, and pain prescriptions as classes frequently overprescribed or associated with harmful side effects. Sleeping pills, for instance, are linked to dementia and falls, with Health Canada recommending their use be limited to two weeks. Similarly, long-term use of proton pump inhibitors for heartburn can interfere with nutrient absorption and increase pneumonia risk, while opioids and seizure medications like gabapentin can cause sedation and confusion.
How to Approach Deprescribing
Patients should not attempt to stop medications on their own. Instead, they should work with a healthcare provider to create a discontinuation plan that involves tapering doses slowly over weeks or months. Successful deprescribing requires clear communication and a shared decision-making process. Sadowski notes that in her experience, intentional, monitored deprescribing is successful more than 80% of the time.
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This article was independently rewritten by ManyPress editorial AI from reporting originally published by Medical Xpress.
