Deprescribing – what does it mean for you as a patient?
Modern medicines improve our survival and reduce our symptoms for a range of medical conditions. In fact some medicines may be considered life changing and life saving. However many patients have more than one medical condition and often can see 2 or more specialists about their conditions. This can often result in each specialist and your GP all prescribing medicines for separate conditions, resulting in a significant number of medications or polypharmacy. The other term that is sometimes used is “medication load”
We also know that the higher the medication load the more likely an adverse effect will occur as a result of interactions between the medications or the multiple conditions. We also know that older, more frail patients are more at risk of these adverse effects. Unfortunately, for older patients a frequent complication of increased medication load can be an admission to hospital.
So what is Deprescribing?
Deprescribing is a process of withdrawal of an inappropriate medication, by your GP and/or health professional with the goal of managing polypharmacy and improving quality of life. It doesn’t just mean stopping a medication, it can also mean reducing doses of any of your medications, decreasing the number of times a day a medication is taken. The other part of deprescribing is that it is done in a planned and controlled way and your GP will monitor your progress, assess whether any symptoms have reoccurred and if necessary restart therapy.
So next time you are in getting a refill of your prescription, have a conversation with your GP about whether any of medications can be deprescribed? Especially if you are taking more than 5 regular medications. For example have you been on your medicine for reflux (or heartburn) for years and have had no symptoms in the last 12 months, ask your GP can you decrease this to a lower strength or stop this medication, slowly over a number weeks. Do you have a complicated regimen for medications and often forget doses, ask your GP if there is any way to simplify the way you take your medicines? Is your loved one having lots of falls at home? Talk to the GP about this, maybe some medications are putting them at higher likelihood of falls?
• Medication withdrawal should be considered as a part of regular medication review.
Remember to ask your GP
• It is joint decision making between GP and (you) the patient, about which medication to deprescribe will improve success.
Make sure you create a follow up plan.
• Trial withdrawal of one medication at a time only.
Indications for the use of many medications may change with time, and medication that was clearly needed in the past may no longer be so.
Deprescribing is associated with improved survival, while having benefits including decreased health care costs, reductions in adverse effects of medications, improvements in medication compliance and increased patient satisfaction.
Go ahead and have a conversation with your GP today!!