Deprescribing medications

Leanne Te Karu talks with us about deprescribing medications. Leanne is a prescribing pharmacist with over 25 years experience across a wide range of settings. She has worked for the quality safety commission and also BPAC. Leanne was a founding member of the Māori pharmacists association and was the inaugural recipient of clinical pharmacist of the year award. Within the general practice environment she aims to optimise safe prescribing while decreasing mortality.

Case

A 76 year old Māori female. She has a past medical history of hypertension, depression, hyperlipidemia, osteoporosis and gout which is currently in remission.

She is taking multiple medications including an ACE inhibitor, a beta-blocker a statin, benzodiazepine and an SSRI. She was also on a bisphosphonate. Periodically she takes a PPI and a Non-steroidal.

Recently she has had falls. She appears to be frail. She presents with her family asking if she can stop some of these medications.

Topics

How would we approach this case?
How do we assess frailty?
Anxiety and consequences of deprescribing
What should our plan and approach look like?
Stopping the various classes of medication.
Is stopping a medication due to age, Ageist?
Are specific groups at greater risk of polypharmacy?
Our communities and Māori population
What strategies can be used to address disparities?

Take home messages

Think of optimisation and individualisation, balance and equity.
Consider frailty and classify for it in your PMS.
Consider an audit in your practice.
Work closely with your pharmacist.

Resources

Medstopper Web app
Variation in the use of medicines by ethnicity in New Zealand The New Zealand Medical Journal

Patient Resources

Presenter

Leanne Te Karu

Pharmacist

To contact Leanne Click here.

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The Goodfellow Unit podcast is funded in part by the Royal New Zealand College of General Practitioners.