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Deprescribing Medication

07/09/2024

Deprescribing is the process of systematically reducing or stopping medications that may no longer be beneficial or may be causing harm. The goal is for your doctor to manage polypharmacy and improve outcomes. It involves a doctor evaluating each medication a person is taking, considering their current health status, and determining if the benefits of the medication outweigh the risks. This can only be done by your healthcare provider.

Steps to Determine if Deprescribing is Appropriate

  • Your Doctor Will:

    1. Review Medication:
       – Compile a List: Make a comprehensive list of all medications you are taking, including prescription drugs, recreational chemicals, over-the-counter medications, supplements, and herbal remedies.
       – Check Indications: Review each medication to ensure there is a current, valid indication for its use.

    2. Assess Risks and Benefits:
       – Evaluate Efficacy: Determine if the medication still provides the intended benefits.
       – Identify Adverse Effects: Consider any side effects or potential for harm associated with the medication.
       – Drug-Drug Interactions: Review interactions between medications that could cause harm or reduce efficacy.

    3. Consider Patient Factors:
       – Health Status: Evaluate the patient’s current health status, life expectancy, and goals of care. Deprescribing is often more appropriate in older adults or those with multiple chronic conditions.
       – Preferences: Discuss the patient’s preferences, values, and concerns regarding their medications.

    4. Prioritize Medications for Deprescribing:
       – High-Risk Medications: Focus on medications with a higher risk of adverse effects or interactions.
       – Medications without a Clear Benefit: Identify medications that no longer benefit the patient.

    5. Develop a Deprescribing Plan:
       – Gradual Reduction: Taper medications slowly to avoid withdrawal symptoms or disease recurrence.
       – Monitoring: Monitor the patient closely for any adverse effects or changes in their condition during and after the deprescribing process.

    6. Collaborate with other Healthcare Providers:
       – Interdisciplinary Approach: Work with a team of healthcare providers, including pharmacists, primary care physicians, and specialists, to ensure a safe and coordinated approach to deprescribing.

    Tools and Guidelines

    Several tools and guidelines can assist your doctor in the deprescribing process:

    – Beers Criteria: Provides a list of potentially inappropriate medications for older adults.
    – STOP/START Criteria: Identifies medications that may be inappropriate (STOP) and those that should be considered (START).
    – MedStopper: An online tool that helps guide the deprescribing process by suggesting which medications to consider stopping first.
    – Deprescribing Guidelines: Specific guidelines for deprescribing classes of medications such as proton pump inhibitors, benzodiazepines, antipsychotics, and more.

    When is Deprescribing Appropriate?

    Deprescribing is appropriate when:

    – The medication is no longer needed (e.g., a condition has resolved).
    – The medication poses more risks than benefits.
    – The patient is experiencing significant side effects.
    – There is a desire to reduce polypharmacy and simplify the medication regimen.
    – The patient’s life expectancy is limited, and the focus is on quality of life rather than disease prevention.

    Conclusion

    Deprescribing is a vital part of managing medications by your doctor, particularly in older adults or those with multiple chronic conditions. It requires careful consideration of the patient’s overall health, the benefits and risks of each medication, and close collaboration with healthcare providers to ensure a safe and effective reduction or cessation of medications.
  • Under no circumstance should you make any change to your medication regime without consultation with your doctor.

Hal Meyer and The ADD Resource Center offer specialized behavioral intervention and educational services for ADHD. They empower adolescents, adults, couples, and their loved ones to manage ADHD symptoms and reach their full potential. They have the expertise to provide personalized guidance and unwavering support on the journey to success.

Harold Robert Meyer /The ADD Resource Center –  http://www.addrc.org/ – 646/205.8080  07/09/2024

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