Follow Canada's Deprescribing Team on Twitter! @Deprescribing

https://mobile.twitter.com/Deprescribing/tweets

#Deprescribing - working together to reduce meds taken by seniors to improve quality of life. Funded by @ONgov with @open_pharmacy & led by @BruyereResearch

Definition of Deprescribing here:

https://drive.google.com/file/d/0B7f2RNdfoQuMTHNlejFROGw4Njg/view

Targeting benzodiazepines and other drugs.  Lots of great links to articles in the tweets!

Moving ahead, little by little.

Ali

Wow! Great! Thank you for these links, Ali!

This description of "deprescribing" is quite wordy but interesting, nevertheless. I'm wondering if it all gets put into practice, though. For most of us here, the answer is no. I guess it's something to strive for. Doctors should obviously be reassessing a person's medications each and every time s/he sees the patient. To me, it's part of the job.

You know Lapis, I think doctors are struggling.  My GPs put in software in their practice a year or so ago, I notice that they struggle to keep my medication list up to date (it never seems to be).

I don't know how in 5 to 7 minutes, they have time to review all of this.  It seems to me that we need to move towards an interdisciplinary approach where clinical nurse specialists can tackle some of these issues in coordination with GPs - perhaps as "point people" where they can sit down with a patient and figure out exactly what they are on and work with the doctors to help taper them.

It is labour intensive and takes time to work with patients 1 on 1, especially seniors.  I can't see my GP being able to carve out this time.  Psychiatrists seem to be moving towards shorter appointments for "med management" too, they don't seem to be aware of the other meds that patients are on.  Case in point, my girlfriend's psychiatrist did not know that she has metabolic syndrome (high blood pressure, type II diabetes, high cholesterol) when I sat in on an appointment at her request and I raised it.  She is on Abilify which can greatly contribute to metabolic syndrome yet he seemed to be completely caught off guard by this.  No wonder psychiatric patients have shortened lifespans - sometimes by 20 or 25 years!  They seem to have walked away from "medicine", it boggles my mind.

Rant over!

Ali

Ah, so many important points in there, Ali!

First, the limited time doctors have.....Back in the ol' days, nurses used to do an intake sort of thing, and then the doctor would come in afterwards. I have a specialist who does that, but my GP doesn't. I know it's about limited resources and how to spend our tax dollars wisely, but it's difficult to make it work. Once, when I had a more in-depth question, I was referred to a nurse practitioner within my GP's office, and she really took the time to talk to me about a specific medication question. I was so grateful for that appointment, since it clarified for me that I'd been put on an inappropriate medication.

Don't get me started on a rant about the field of psychiatry, though! It really is all about the medication. Zero counselling. To me, it's wrong. It's based on an understanding of the human mind that I don't believe in. I listened to a great noon-hour program on CBC Radio last year sometime, in which the psychiatrist was lamenting the changes that have taken place in his field. He reminisced fondly about the time the focus used to be counselling and the doctor-patient relationship. He was very clear that the medications have disappointing results in his experience. I loved that program -- so honest. The callers had LOTS to say, as you can imagine.