Week 7 - Deprescribing

Question 1

What is deprescribing?

Answer 1

• reducing or stopping medications that may not be beneficial or may be causing harm

Question 2

What is the goal of deprescribing?

Answer 2

• maintain or improve quality of life

Question 3

Which persons does deprescribing involve? (4)

Answer 3

patients
caregivers
HCP
policy makers

Question 4

Why does deprescribing prevent prescribing cascade? (2)

Answer 4

• consider each new symptom the patient presents as a possible ADE to prevent prescribing cascade
• encourage non-pharmacological approaches for behaviour (medications prescribed for behaviour)

Question 5

What information can we collect on factors impacting medication use and safety? (5)

Answer 5

• what influences a person to take their medication
• look for potential of med interactions
• recognize conditions that make it difficult for the older adult to self medicate
• recognize frailty, as there is potential for fluid depletion of malnutrition
• identify medication that could exacerbate disease or geriatric syndromes, using BEERS criteria

Question 6

How can we monitor and evaluate the effective medication? (4)

Answer 6

1. reaching goals of medication
   ie. analgesic for pain = assess pain
2. Focus on improved function for the older adult (ADLS)
3. Identify if there are any changes in the following:
   - sleep, eating (appetite), elimination, blood levels for some medications
4. Identify any changes indicating potential geriatric syndromes

Question 7

What are identifiers of potential geriatric syndromes? (4)

Answer 7

Changes in mental status
- attention, alertness, memory, orientation, behaviour, mood, affect
- interactions
- increased risk for falls: orthostatic hypertension