Financial advantage or barrier when deprescribing for seniors: A ‘case based’ analysis

Fadaleh, Sarah M. Abu; Shkrobot, Jody; Makhinova, Tatiana; Eurich, Dean T.; Sadowski, Cheryl A

doi:10.1016/j.sapharm.2020.03.003

Cited by 5 publications

(8 citation statements)

References 11 publications

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“…Although medication costs and coverages differed significantly from province to province, overall deprescribing scenarios across the country typically reduced patient costs and lowered pharmacy income with minimal impact on government costs. 19 Together, these 3 studies show that if deprescribing practices are continuously adhered to, a beneficial decrease in patient costs is noted.…”

Section: Resultsmentioning

confidence: 95%

“…In this literature search,3 studies examined the financial implication of deprescribing. 17 - 19 Using pharmacist-led educational interventions, 1 study discovered that deprescribing nonsteroidal anti-inflammatory drugs in community-dwelling older adults was beneficial and cost-effective. 18 In another study, deprescribing PPIs in long-term care facilities initially showed a significant reduction in the average cost of PPI prescriptions.…”

Section: Resultsmentioning

confidence: 99%

“…In this literature search,3 studies examined the financial implication of deprescribing. [17][18][19] clinical review…”

Section: Financial Effects Of Deprescribingmentioning

confidence: 99%

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Deprescribing practices in Canada: A scoping review

Desai¹,

Park²

2022

Can Pharm J

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Background: Excessive and inappropriate use of medications, defined as polypharmacy, can increase the risk of adverse drug reactions while affecting patient adherence and quality of life. Therefore, optimizing pharmacotherapies through deprescribing practices plays a crucial role in managing chronic conditions, avoiding adverse effects and improving patient outcomes. The purpose of this study was to explore research initiatives surrounding deprescribing in Canada. Methods: A scoping review was conducted that involved a search of 6 databases. Studies that highlighted deprescribing interventions, experiences and other effects on Canadian populations were included. Results: Searches yielded 2327 citations, of which 31 were included in this review. Five major themes and ideas were identified: deprescribing targeted medications, financial effects of deprescribing, deprescribing in special populations, insight from health care providers and deprescribing frameworks. Conclusion: Deprescribing practices in Canada have shown a wide range of beneficial results across various health care settings, populations and medication classes and have the potential to reduce medication-related harm in all Canadian health care settings.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

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Deprescribing practices in Canada: A scoping review

Desai¹,

Park²

2022

Can Pharm J

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“…Deprescribing is a method of reducing drug dosage, changing a drug to a safer alternative, or discontinuing a drug without a specific indication or added benefit, under the supervision of a healthcare practitioner, and can be used to resolve inappropriate medication use in the elderly population. 1,2,4 Coronavirus Disease (COVID-19) is a recent infectious disease that attacks the human respiratory system leading to symptoms, such as fever, cough, and fatigue. [5][6][7] The mode of transmission of this virus is person-to-person through the transfer of respiratory droplets.…”

Section: Deprescribing Contextmentioning

confidence: 99%

“…10 A recent study that evaluated the financial impact of 8 different deprescribing scenarios on a typical patient case across different provinces in Canada showed that deprescribing can save money for the patient (0.03%-87.4%) and government (0.38%-15.77%). 4 There are several deprescribing initiatives in place in different provinces in Canada, such as UBC Pharmacists Clinic in British Columbia, Prairie Mountain Health Sedative Describing Initiative in Manitoba, Medication Therapy Services Clinic in Newfoundland and Labrador, Winchester District Memorial Hospital Describing Program in Ontario, and Agir pour mieux dormir program in Quebec. 10 The partnership between patients, caregivers, and healthcare practitioners is instrumental to the success of deprescribing and due to COVID-19, these interactions have been interrupted.…”

Section: Deprescribing Contextmentioning

confidence: 99%

Barriers to conducting deprescribing in the elderly population amid the COVID-19 pandemic

Elbeddini

Prabaharan

Almasalkhi

et al. 2021

Research in Social and Administrative Pharmacy

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Deprescribing aims to reduce polypharmacy, especially in the elderly population, in order to maintain or improve quality of life, reduce harm from medications, and limit healthcare expenditure. Coronavirus disease (COVID-19) is an infectious disease that has led to a pandemic and has changed the lives many throughout the world. The mode of transmission of this virus is from person to person through the transfer of respiratory droplets. Therefore, non-essential healthcare services involving direct patient interactions, including deprescribing, has been on hiatus to reduce spread. Barriers to deprescribing before the pandemic include patient and system related factors, such as resistance to change, patient's knowledge deficit about deprescribing, lack of alternatives for treatment of disease, uncoordinated delivery of health services, prescriber's attitudes and/or experience, limited availability of guidelines for deprescribing, and lack of evidence on preventative therapy. Some of these barriers can be mitigated by using the following interventions:patient education, prioritization of non-pharmacological therapy, incorporation of electronic health record (EHR), continuous prescriber education, and development of research studies on deprescribing. Currently, deprescribing cannot be delivered through in person interactions, so virtual care is a reasonable alternative format. The full incorporation of EHR throughout Canada can add to the success of this strategy. However, there are several challenges of conducting deprescribing virtually in the elderly population. These challenges include, but are not limited, to their inability to use technology, lack of literacy, lack of assistance from others, greater propensity for withdrawal effects, and increased risk of severe consequences, if hospitalized. Virtual care is the future of healthcare and in order to retain the benefits of deprescribing, additional initiatives should be in place to address the challenges that elderly patients may experience in accessing deprescribing virtually. These initiatives should involve teaching elderly patients how to use technology to access health services and with technical support in place to address any concerns.

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