Q: Can you explain your new program targeting higher-risk medications for deprescribing?
A: The program involves training modules, each with on-demand video or PowerPoint, a deprescribing algorithm and a podcast demonstrating how to have discussions with patients and others. So far, we have completed modules on deprescribing anticholinergic bladder agents, proton pump inhibitors, dementia medications and oral antihyperglycemics.
Q:Were you surprised to cut use of some meds by 40% or more?
A: Most deprescribing campaigns report 25% success rates. We expected some hesitancy from primary care physicians and consultants about deprescribing in general, but it was most noticeable with the dementia medications. … We attribute our success to relationships with patients and families and efforts to educate them. Like advance care planning conversations, deprescribing conversations are rarely “one and done.” It takes time to explain risks vs. benefits.
Q:As AMDA’s 2021 Choosing Wisely Champion, what advice do you have for others in the business?
A: There is certainly room for improvement to periodically reevaluate a patient’s medications and taper and discontinue when no longer benefiting the patient, or if the risk outweighs the benefit. I look forward to a culture change.
