BC Provincial Deprescribing Webinar Series #6

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 hoped.  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 through our popular Deprescribing Webinar series initiated in February 2023.  Learning together, we hope to build confidence and knowledge about deprescribing in BC and beyond. The sessions are engaging (often including videos documenting the patients’ experience) and interactive, with ample opportunity for the participants to ask questions and share insights. Each Deprescribing Webinar is recorded and the video recording is made freely available after the live event. The next Deprescribing Webinar is scheduled for Wednesday, March 13, 2024 (details below).

Case 1: Hallucinations from drug treatment for Parkinson’s disease

Presented by: Juan Maria Rubio Lopez MD, MSc (Gerontology), PhD candidate

Dr. Rubio Lopez is a primary care physician who directs the Martos Health Care Centre of the Servicio Andaluz de Salud in Jaén, Spain. He teaches medical and post-graduate students and is also a doctoral candidate in the Inter-University Health Sciences Program of the University of Jaén.

LEARNING OBJECTIVES:

By the end of this presentation, attendees will recognize that:

1. New symptoms or signs after a change in medication may be adverse drug effects, and hence reversible.
2. A crisis arising from one medication can be an opportunity for more comprehensive reassessment of drug therapy and for deprescribing.
3. A primary care provider must sometimes overrule specialists who are unaware of a patient’s evolving condition.

Case 2: Patient-led Deprescribing

Presented by: Sadie Quintal, BScPharm, RPh, CDE

Sadie Quintal is a Primary Care Clinical Pharmacist working with the Comox Valley Primary Care Network of physicians and nurse practitioners on Vancouver Island, British Columbia. She has a background in hospital clinical pharmacy, but now works within prescribers’ offices to review patients with complex polypharmacy or suspected medication problems.

LEARNING OBJECTIVES:

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

1. Develop an approach to collaborate with a patient and prescriber in the face of complex health issues, complicated polypharmacy, and potentially serious long-term adverse drug effects.
2. Understand how a constructive approach may prove surprisingly helpful, in what at first appears an intractable problem.
3. Appreciate that diplomacy and patient advocacy sometimes go hand in hand.