Inappropriate polypharmacy, particularly in older patients, can bring with it a whole host of problems. Disability, adverse drug effects, hospitalisation and general poor health can all follow, not to mention death.
The risk of adverse drug affects, particularly in the elderly population, is much higher the more drugs a patient is prescribed. This may mean a process of deprescribing is something that’s required.
Deprescribing means reducing the amount of drug a patient is on, or stopping the drug altogether. This should reduce the risk of polypharmacy as well as improve patient outcomes.
New evidence of efficacy for deprescribing is being released all the time. A deprescribing protocol is proposed comprising 5 steps:
1.Ascertain all drugs the patient is currently on, and why they’re on them.
2.Consider overall risk of drug-induced harm in individual patients when determining the required intensity of deprescribing intervention.
3.Assess each drug in regard to its current or future benefit potential compared with current or future harm or burden potential.
4.Prioritise drugs for discontinuation that have the lowest benefit-harm ratio and lowest likelihood of adverse withdrawal reactions or disease rebound syndromes; and
5.Implement a discontinuation regimen and monitor patients closely for improvement in outcomes or onset of adverse effects. Whereas patient and prescriber barriers to deprescribing exist, resources and strategies are available that facilitate deliberate yet judicious deprescribing and deserve wider application.
Are you a healthcare professional looking to expand your knowledge in this diverse area?
If so, there are two courses offered here at PDUK that may well be of interest.
The first one is our Medicines optimisation in Hypertension and Heart Failure online course. Perfectly suited to nurses and allied health professionals looking to stay current in this field, the course focuses on pharmaceutical management of patients with hypertension and cardiac failure. It looks at important issues that non-medical prescribers deal with such as polypharmacy and patient monitoring. Structured medication reviews are discussed along with current guidelines.
Held as an interactive online session, it’s worth 4 hours of CPD over half a day.
Then you’ve also got our Medication reviews, structured medicines reviews (SMRs), medicines optimisation and deprescribing course. It’s primarily aimed at healthcare professionals including nurse practitioners and pharmacists looking for more information on effective medication reviews and how to deprescribe medicines. This includes non-medical prescribers as well as practitioners who are interested in medications reviews. Again it’s worth a valuable 4 hours of CPD over half a day.
Spaces on both courses are limited so make sure you sign up as soon as possible!