BC Provincial Deprescribing Webinar Series #2

When challenged by complex cases involving people taking too many medications, we may ask:

Can I stop any of these?
Which should I stop first?
Do I need to taper this drug? If so, how?
What should I monitor for after stopping, and when?

Many clinicians address these clinical questions successfully, improving outcomes for patients. Sometimes, things don’t work out as we hope. At the Therapeutics Initiative, we want to create a platform for healthcare providers, patients, caregivers, advocates and policy makers to learn from each other about successes and challenges in deprescribing. Learning together, we hope to build confidence and knowledge about deprescribing in BC and beyond.

Case #1: “Tapering Trial and Errors: A Pharmacist’s Perspective

Pharmacists are frequently involved in the care of patients with polypharmacy, and can typically identify a number of strategies to optimize a medication regimen, including deprescribing. Difficulties arise when medications are started by multiple different prescribers and when there is resistance to changing treatments that were prescribed by a specialist, even when they may no longer be working for the patient.

There can be further challenges when a patient’s preferences and goals of therapy do not align with a specialist’s approach or with evidence-based guidelines. This case highlights nuances of deprescribing effectively and safely in primary care, while preserving relationships and interprofessional collaboration.

Case #2: “Deprescribing nearing End of Life: How Partnership and Shared Care Goals Play a Role”
The purpose of the presentation is to share details about a frail older adult at the latter stages of life on multiple medications with uncertain benefit. Then to demonstrate after establishing care goals with the person and with family partnership, deprescribing can be more meaningful when consistent with shared care goals.

LEARNING OBJECTIVES
By the end of the presentation, attendees will be able to:

1. Recognize when a medication list is not appropriate for a patient’s long-term health
2. Begin to develop a plan to simplify by deprescribing potentially harmful or redundant drugs.
3. Identify helpful collaborators (pharmacists, specialists, or other colleagues) who can assist with successful deprescribing