HEALTH: Less is More: Deprescribing for Better Health

Deprescribing2

In 2016, approximately 1 in 3 NLers over the age of 65 were prescribed 10 or more drug classes, 12% higher than the Canadian average. Pharmacists and researchers at the Medication Therapy Services (MTS) clinic, run by Memorial University’s School of Pharmacy, are tackling this complex issue of overprescribing medications, one pill at a time.

“We offer one-on-one, appointment-based pharmacist consultations in a private clinic environment at no cost to the patient,” explains Dr. Cathy Balsom, a clinic pharmacist at the MTS clinic. “We work with doctors, nurses and community pharmacists to provide optimal care for patients with complex drug-related needs.”

In 2017, the MTS clinic undertook a study with St. Patrick’s Mercy Home (a long-term care facility for seniors in St. John’s) and Lawtons nursing home services to assess the medication prescriptions of residents, and determine what medications could be
changed, decreased, or stopped altogether to increase the overall health and well-being of the patients.

“I don’t think people realize how many medications they take,” says Dr. Balsom. “The residents at that home who were generally healthy still took, on average, 14.5 medications per day.”

Just three months after they started working with St. Pat’s, the clinic found that the residents had successfully reduced their intake to 12.5 medications per day, and after 6 months, this number further reduced to 12.

On average, 2.5 medications per resident were taken away with no detrimental effects to their overall health and well-being.

he residents themselves were happy to be weaned off unnecessary drugs, with many citing the money they would save as a result. Employees at the complex also noted improvements.

“Patients seem a lot more alert now. There have been anecdotal stories, such as when a patient who had been verbally repetitive started speaking in full sentences after we took away one of their medications.”
Dr. Cathy Balsom, Clinic Pharmacist, MTS Clinic

“The nursing staff would say, patients seem a lot more alert now. There have been an- ecdotal stories, such as when a patient who had been verbally repetitive started speaking in full sentences after we took away one of their medications.”

Balsom understands that pharmacy is a business, responsible for the dispensing of medications, but she still hopes that studies such as this one—combined with a shift from pharmacy being seen as product-focused to patient-focused—can trigger a cultural change in how we look at medication and overall health.

“When we think of our experience with medications in the past, there was a generation that sought a medication for every ailment,” says Dr. Balsom. “A pill for every ill. Now I think we’re really looking at people more holistically, and considering other avenues, such as cognitive or physical therapies that are equally effective treatments.”

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