A Closer Look at Deprescribing

In its simplest definition, deprescribing involves reducing the number of prescribed medications for a specific patient. The reasons for this reduction are numerous. Perhaps the patient no longer receives any benefit from a certain drug? In other cases, prescribing too many medications might even cause harm to the patient.

As community pharmacies and their pharmacists increasingly provide direct patient care, deprescribing becomes a critical piece of their toolkit. It requires a detailed knowledge of a patient, their evolving health situation, and their current array of prescriptions. If possible, partnering directly with the patient’s primary care physician (PCP) is essential when deprescribing.

Understanding the Most Common Reasons for Deprescribing

Let’s examine a few of the most typical reasons for medication deprescribing.

·         Medication no longer providing benefits or is causing undesired side effects

·         Patient successfully manages a health condition without medication

·         Increasing risk of harmful drug interactions due to a patient requiring more medications

·         Patient reacts to an existing medication in an unexpected manner

Long-term usage of certain medications also might be problematic with some patients. Additionally, the patient's age might play a role in a deprescribing decision. For example, some medical conditions don’t require a strict regimen of medications when a patient gets older.

Deprescribing can be a critical contributor to patient health.

Considering the inherent complexity of any deprescribing scenario, it bears repeating that interaction between physician and pharmacist becomes crucial. This is especially the case when considering the third reason from the above list. Each time a new prescription is necessary, both medical professionals must analyze the patient’s current list of medications. Preventing the adverse effects of drug interactions (including OTC medications and dietary supplements) is critical.

Patients enjoy Multiple Benefits from a Proactive Deprescribing Approach

Patients reap a variety of benefits when their healthcare providers adopt a proactive approach to deprescribing. Of course, preventing adverse drug interactions ranks at the top of any list of benefits. Additionally, lowering the number of medications taken each day makes it easier for patients to manage this responsibility. Expect fewer missed doses as a result.

Considering the costs of pharmaceuticals, reducing the number of prescriptions ultimately saves money. This becomes especially important for poor and/or older patients with limited budgets. In the end, most patients ultimately enjoy a higher quality of life because of deprescribing.

Is Deprescribing Safe?

In most situations, deprescribing when directed by your PCP is a very safe process. When your care provider decides on a deprescribing program, they may stop certain medications immediately. This is typically the case with any dietary supplements, including vitamins.

In other cases, a gradual reduction in the dosing amount is a better approach. Remember to never stop taking a prescribed medication on your own without first speaking with your PCP! Remember, a trusted community pharmacist is another helpful source for advice on deprescribing.

Your Community Pharmacy has Deprescribing Knowledge and Experience

If curious about whether you currently have too many prescriptions, contact your primary care provider and community pharmacist. When working together as a team, they offer keen insights and helpful advice on any potential adverse drug interactions.

Be upfront with them on your current health situation, including any recent illnesses or other events potentially related to your prescriptions. Also, provide a list of your current medications and any dietary supplements you are taking.  

The deprescribing process also highlights the benefits of using a community pharmacy leveraging Seguridad’s Choose My Pharmacy™ rating system. The health measures in the system track a patient’s record of prescriptions and specific dosing regimens. This critical data helps avoid adverse health events due to incorrect dosing amounts while also informing any deprescribing approach. 

Check out this article from JAMA Internal Medicine for additional easy-to-understand information on deprescribing.