Deprescribing: it’s a shared decision

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1M ago 18:25

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Deprescribing is “about working together to make sure that the medication someone is taking still fit with the current health goals, the values and their needs at that point in their life,” says one expert

Pharmacist Amanda Quek is currently working on her PhD, focused on developing clinical practise guidelines for deprescribing common medications used by older people.

She told AJP Podcast host Carlene McMaugh that it’s vital to take a “pragmatic personalised approach when it comes to prescribing and deprescribing”.

“This just means that understanding what matters to the person, the values and preferences and priorities for treatment, other expects that are important is to consider the person acceptability to deprescribing the support system life expectancy and ability to safely manage changes in treatment,” Quek says.

“And I think the shared decision making and clear communication between the patient and the healthcare providers is especially important.

“People need to feel supported and reassured, especially when stopping a medication they’ve been on for a long time.”

Quek notes that health professionals often note a lack of clear structure to support desprescribing.

“An effective literature review published last year found that around 70% of all clinical practice guidelines for treatment don’t include any guidance about deprescribing,” she tells McMaugh.

“And most of them focus heavily on when to start a medication but rarely offer advice on when or how to safely reduce and stop them.

“And there’s a huge missed opportunity.”

01:04 – What is deprescribing and why does it matter?

02:53 – “Deprescribing isn’t just about managing a medication list, it’s about looking at the whole person.”

05:43 – Gaps and challenges to address

08:37 – What do these guidelines add to the existing evidence that supports deprescribing?

09:56 – The team that put the guidelines together – including patients and carers

12:53 – “One of the most valuable things we learned from them was just how critical clear communication is in healthcare.’

14:06 – What does this feedback mean for pharmacists and for patients?

16:02 – How to share feedback

17:01 – “The main thing is just to remember for both patients and pharmacists is that deprescribing is a team effort.”

You can access the full transcript of this podcast here. While we endeavour to ensure all important words and phrases are correct, please note there may be some minor inaccuracies in the transcription.

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