Deprescribing: Beginning the Process (Part 2)

You can start the process of deprescribing by doing some research and learning more about the medications you take.

Deprescribing (as discussed in part 1) is the process of determining whether you are taking medications that may no longer be needed and identifying possible changes or reductions in dosage of any medications. Taking these steps may improve your health and reduce the chances of your experiencing side effects or having an adverse reaction to your medications.

It’s important you keep in mind a few medication facts while you approach this process:

  • Some medications should not be stopped. Recognize that your medical condition may require that you continue taking some medications to keep things under control. However, it may be appropriate to change a medication that is causing a problem.
  • There are medications that you should not abruptly stop taking. Some drugs need to be tapered off slowly to avoid problems. A gradual reduction of dose over a few weeks or months will usually prevent the problems experienced when suddenly halting a drug.
  • It’s important to not stop taking any medication without your doctor directing you to do so.

Taking prescription medications to treat your medical condition is serious business. Deprescribing isn’t something you can do on your own. The process of deprescribing is basically the same, whether for yourself or another member of your family you might care for. You’ll need to work with your physician or healthcare provider to determine the best course of action.

1. Prepare before talking with your doctor. Let the office know you want to discuss your medications when you make the appointment. Visits with your doctor are always time-sensitive, but being adequately prepared makes it easier. Before talking to the doctor, make a list of all prescription medications, non-prescription medications and vitamin or herbal supplements you take. Make sure you include medications that were prescribed by other doctors. Click here for a form you can use for your medication list (or click on the image of the form).

It’s important to include if the drug has a side effect that is bothersome — perhaps one drug upsets your stomach or another makes you feel jittery. Your doctor might be able to suggest an alternative drug or a way to minimize the side effect. A little gastrointestinal discomfort might be a small price for the benefit of the drug, but if it’s affecting your enjoyment of life, a change might be in order.

2. Know the names of your medications, the doses you take, how often you take them and what medical conditions they are prescribed for. If you are uncertain or have questions, you can consult your pharmacist or read the medication handouts included with each medicine. .

3. Expect to be a little uncomfortable. Many people find it downright difficult to have this conversation. Although most people have a desire to work with their doctor, they usually fear two things: They don’t want to “rock the boat” or offend their doctor, and they feel there isn’t time enough to ask questions. Don’t let this stop you from talking to your doctor. Both of these situations can be overcome with some preparation like alerting your doctor’s office ahead of time about reviewing your medicines and having the list ready to share.

I’ve worked with physicians to make medication changes for my pharmacy patients and my family members for years. Most of the time physicians appreciate the input because they have your best interests at heart. Often they can feel rushed and accidently overlook something during office visits. Sometimes they just want to keep the status quo if everything seems to be working. Other times they just get into a routine of prescribing certain drugs when there may be other options.

Don’t be afraid to ask your doctor questions. If you don’t feel comfortable doing this on your own, enlist the help of a companion or other family member to advocate for you at your office visit.

Dave Walker, RPh

Dave Walker, RPh, is a pharmacist and a member of the MedShadow medical advisory board. He has practiced in multiple pharmacy settings as a pharmacy owner, hospital director of pharmacy, district manager for a pharmacy staffing agency, and currently director of pharmacy at a rural, nonprofit clinic and pharmacy. You can follow him on Twitter @drwalker_rph.

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