De-prescribing medications to improve your health or Which drug can I stop first?

overmedicated pharma

By Cara Tannenbaum, M.D. Geriatrician and Pharmacy Chair in Health and Aging, University of Montreal.

Are you worried about the side effects of the medication you are taking?

According to a report released by the Canadian Institute for Health Information, nearly two-thirds of adults aged 65 years and older take at least five prescription drugs and more than 40 per cent of Canadians age 85 and older take 10 drugs or more per day. That is an alarming figure.

It is therefore not surprising that 88% of older women and 63% of older men across Canada express concern about the side effects of their medications.

In Canada, we have a lot of practice prescribing drugs to help manage health ailments but our doctors and pharmacists have very little knowledge about how to de-prescribe drugs.

Data shows that at least 25% of seniors take medication paid for by government that is potentially inappropriate. By inappropriate, we mean causes more harm than good. There is a well-established list of the top 10 drugs to avoid.

The Choosing Wisely Canada campaign, which was launched earlier this year, encourages patients to take a closer look at which drugs are inappropriate and should be gotten rid of.

De-prescription is important for older adults who may not actually need a drug after a given period of time or are taking a drug that could have side effects that put their overall well-being at risk.

For example, research published on September 10 in the British Medical Journal suggested that taking sleeping pills at least twice weekly increases the risk of Alzheimer’s disease.

So what can older adults in Canada do?

The first and most important step is to educate yourself about what medications you are taking and why. The second step is to engage in a discussion with your health care provider about de-prescription options and alternative therapies.

Discussion is growing around the concept for Canadas health care systems to shift some funding from the prescription of medication to alternative therapies and de-prescribing. This approach could save governments money due to decreases in health costs associated with prescription medication interactions and hospital visits.

Sleeping pills, for example, are responsible for one-in-five emergency department visits by adults taking medication for mental health disorders. Confusion, falls, fractures and head injuries are only a few problems caused by sedative-hypnotic drugs. Using sleep aids will double your risk of death, even if you are otherwise healthy. Sleeping pills should definitely be the first prescription drug to get off of.

If you are interested in learning how to start a conversation with your health care provider on this important topic, you can download our de-prescribing brochure.

Discuss with your doctor or pharmacist whether it its good for you to start following the simple-to-use tapering protocol that has been developed to minimize withdrawal symptoms.

De-prescribing is just starting to gain traction in medical circles and among government legislators. Understanding your options and asking the right questions to health care providers and elected officials is an important step in the right direction.

Dr. Cara Tannenbaum is a Professor at the University of Montreal and the Chair in Geriatric Pharmacology, Health and Aging. She was the lead researcher in the study, Reduction of Inappropriate Benzodiazepine Prescriptions Among Older Adults Through Direct Patient Education: The EMPOWER Cluster Randomized Trial, which was published in JAMA Internal Medicine in June 2014.