Medications can drastically improve people’s lives, especially those with chronic conditions, such as high blood pressure, diabetes, mental illness, high cholesterol, cancer, and chronic pain. But taking too many prescribed medications can be dangerous.
When your patients take more than five medications, it’s called polypharmacy. With this, there are risks, such as harmful effects, drug interactions, and an increase in hospitalizations. Overall, 13% of people in the U.S. take five or more prescription drugs. For people who are 65 or older, that number is 42%.
When one pill leads to a side effect, it can lead to another pill and another side effect. This is known as a “prescribing cascade.” If taken for years, some drugs can cause harm while others stop working or interact badly with a new medication. Even though a drug can be tolerated well at first, it can later cause side effects and lead to cognitive decline and possible injuries from falls.
This is why deprescribing is crucial to patient care. With it, there’s a systematic review and reduction of medications that are either unnecessary or have the potential to be harmful. Here is what it can do for patients:
- Lessen side effects. Some medications have side effects that can make health conditions worsen or cause new issues.
- Prevent drug interactions. Taking multiple medications runs the risk of harmful drug interactions. Deprescribing can help minimize the risk of drugs not mixing well.
- Simpler regimens. The fewer medications your patients take, the simpler their regimens. This can improve their adherence and ensure they take their medications as prescribed.
- Better quality of life. With fewer medications to take, your patients will have less physical and mental burden (especially with complex medication schedules).
- Functionality improvements. Deprescribing can improve a patient’s overall functional status, especially if some of their medications impair cognitive or physical function.
- Decrease healthcare costs. Taking fewer medications reduces costs for patients and the healthcare system. This includes lower expenses for purchasing drugs and managing side effects.
- Support personalized care. By deprescribing, treatment plans can be better tailored to the patient’s current health status, goals, and preferences.
Performing patient medication reviews is vital for multiple reasons. First of all, you’re trained to identify issues such as side effects, drug interactions, and inappropriate dosages. Reviewing your patients’ medications helps detect and resolve any problems. If a medication on their list isn’t needed anymore, here are steps you can take to deprescribe effectively:
- Review the medication list. Assess the current medications your patient is taking. Are they still effective and relevant? Decide which medications are still necessary. Pay attention to drugs that may cause adverse effects, interactions, or have outdated indications.
- Assess the patient’s condition. Check their health status. Review the patient’s overall health, including their medical history, current conditions, and any new health issues. Make sure the medication plan aligns with the patient’s goals and preferences.
- Make medications a priority. Determine risk vs. benefit. Decide the medications with the highest risk or least benefit. Prioritize them for potential discontinuation.
- Speak with the patient and healthcare team. Talk about options. Chat with the patient about the risks and benefits that come with continuing vs. stopping each medication. Invite family members if appropriate. Team up with other healthcare providers to secure a coordinated approach, especially for medications managed by different specialists.
- Make a deprescribing plan. Develop a gradual schedule for tapering if needed, rather than an abrupt discontinuation. This way, you’ll avoid withdrawal symptoms or rebound effects. Plan to closely monitor your patient’s response to the medication changes and adjust the plan as needed.
- Educate your patient. Inform your patient why you’re stopping the medication, potential side effects, and any signs to watch for. Make sure they understand the plan and know who to contact for any questions or concerns.
- Monitor regularly. Schedule follow-up appointments to monitor your patient’s health status and response to the changes in medications. Be ready to make further adjustments based on your patient’s clinical outcomes and feedback.
Document all changes. Be sure to record all decisions and changes made. This includes patient discussions and clinical rationale. Be sure the patient’s medication records have also been updated with recent changes.
Common causes of hospital readmissions are due to medication errors and adverse drug reactions. But your regular reviews can help prevent issues like these, especially if you collaborate with other healthcare professionals to consider all aspects of a patient’s health and treatment. This leads to better patient outcomes and reduced costs.
You give personalized advice and education that helps your patients understand their treatments better and can adhere to their medication regimen with confidence. And with regular reviews of your patients’ medications, you’re able to see that they’re used safely and effectively with the ability to adjust prescriptions as needed, whether it’s from changes in a patient’s health or to new evidence-based guidelines.
Educating your patients provides valuable tips on how to take their medications correctly, what potential side effects they may notice, and the importance of adherence. It also empowers them to take on an active role in managing their health.
When your patients feel empowered, they experience many benefits, such as confidence in health decisions and improved management of their chronic conditions. They engage more with their healthcare providers, asking questions and expressing concerns. Empowered patients
are also more likely to seek and utilize support networks, and more likely to report a greater quality of life and sense of control over their health.
You have the power to empower your patients. So, keep going; they need your support to build their confidence in managing their health.
More articles from the December 2024 issue:
- A New Direction for Continuous Glucose Monitors
- The Prevalence of Osteoarthritis
- Vaccine Overview 2024-25
- Peripheral Artery Disease
- PBMs Exposed
- Cybersecurity in Your Pharmacy
- Diagnosing Alzheimer’s Disease
- Patient Medication Reviews
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