Deprescribing helps patients back off medications if they are no longer required
By Rebecca Kant, D.O.
Nearly 40% of adults over 65 use five or more prescription medications, according to the Journal of the American Medical Association (JAMA)
So how can people be sure they’re genuinely being helped — and not harmed — when taking so many prescriptions?
Proper prescribing should maximize treatment effectiveness, minimize the risk of side effects and drug interactions, reduce costs and respect the patient’s choices.
Overprescribing is most common in the elderly. As people develop new health issues, see multiple physicians or introduce over-the-counter medicines, the chance of overprescribing increases.
Every added medication can lead to more side effects, more interactions with other medicines, and potentially more emergency room visits. Taking a lot of pills every day can be overwhelming and increasingly expensive. Managing this “pill burden” can also be very time consuming and can take away from things seniors truly want to be doing, such as spending time with loved ones or participating in activities they enjoy.
Deprescribing helps patients back off medications when doses are too high or stop them entirely if they are no longer required.
The deprescribing process
The process of eliminating medications from your daily regimen should be planned and supervised by your doctor. Self-advocacy is essential to its success.
Geriatricians at St. Ann’s Community recommend reviewing and updating all your medications with your primary care physician during every office visit. Be sure to include prescriptions, over-the-counter medications and supplements to help your doctor troubleshoot potential problems and address your concerns. It can be helpful to bring a family member or friend with you when you go to the doctor’s office. He or she can help you remember what the doctor says or take notes for you. You should try to keep a copy of your medication list with you at all times in case of an emergency.
For EVERY medication on your list, ask your doctor:
• Why am I taking this medication?
• What are the potential benefits and potentially harmful side effects?
• Will it interact with my other medications?
• Can it affect my memory?
• Can it cause me to fall?
• How long will I need to take it?
What’s on the cut list
Be aware that as your body ages, it becomes less capable of removing waste efficiently, so medicines can take a longer time to be cleared from the body. Due to this, medicines have the potential to accumulate within the body and cause more side effects. As people age, doses may need to be reduced or certain medications may need to be stopped altogether to account for this.
Medications that can increase the risk of falls, worsen cognitive impairment or lower blood sugar top the list of which ones to stop.
Eliminating preventive medicines like aspirin, cholesterol medicines, vitamins and supplements may also be appropriate for some individuals.
Wean yourself safely
Certain medicines require you to slowly decrease the dose, whereas others you can stop right away. You should work with your doctor to develop a plan for you detailing how to stop a medication safely.
So before you decide to pop another pill, ask your doctor if taking it is really in your best interest. Your pharmacist can also help answer any questions, especially regarding side effects and drug interactions.
Receiving the best medicine for what ails you should leave you feeling better, so you have the time, resources, and energy to enjoy life to its fullest.
Rebecca Kant, DO (Doctor of Osteopathic Medicine) is a geriatric physician at St. Ann’s Community and Pillar Medical Associates in Rochester. Contact her at firstname.lastname@example.org or visit www.pillarmedical.com