November 30, 2023

The Importance of Deprescribing for Seniors

About Brookdale Senior Living

Nearly half of American seniors age 65 and older take five or more prescription medications. As medications are added to a person’s profile, the chance for drug interactions and side effects increases. Deprescribing involves routinely monitoring medications and intentionally decreasing or discontinuing prescriptions that are potentially harmful or no longer beneficial.

We invited Todd King, Pharm.D., CGP, to share his insight for Brookdale’s Optimum Life® Continuing Education Series.

King, a Certified Geriatric Pharmacist, has more than 25 years’ experience in long-term care and currently serves as executive director of Clinical Services for Omnicare®, a CVS Health Company.

The Problem of Polypharmacy

Polypharmacy can be a significant challenge among the older adult population. As the number of medications increases, so does the potential number of medication-related problems.

Often, a drug side effect is misinterpreted as a new medical condition, and additional drug therapy is prescribed to treat it. This is referred to as the “prescribing cascade,” and it can prove harmful, particularly for older adults who are more vulnerable to the adverse effects of medication.

Deprescribing is key to help minimize unnecessary medications, reduce side effects and avoid medication errors.

Identifying Opportunities for Deprescribing

Identify opportunities for deprescribing by first looking at the client’s medication list in its entirety:

Have there been any changes to the list?
Are there any apparent duplications?
Does the medication need a stop date, or should it be discontinued?

Also look for changes in the client:

Is there a new symptom or functional change?
Does the treatment seem to be having no impact?
Has illness or frailty progressed significantly?

King suggests considering if there are non-drug interventions to help taper off and stop using high-risk prescriptions when possible.

Deprescribing Is a Team Effort

In the process of deprescribing, prescribers and specialists can tap into valuable insights from the patient and those who regularly interact with them, like caregivers and family members, who have a wealth of historical knowledge.

When talking to the patient or their family about deprescribing, it's helpful to ask straightforward questions. For example, inquire whether they have strong emotional connections to their medications. Try to determine which medications they consider most- or least-important, and whether they're currently experiencing any side effects. Questions like these can help make the conversation smoother and more informative.

When discussing deprescribing with the prescribers themselves, it's important to engage in open and collaborative dialogue. Share your observations and any concerns you may have about potential side effects. Ask them about the monitoring plan they have in mind, and bring up the possibility of tapering off or discontinuing the prescription if it seems appropriate. This approach helps ensure that deprescribing decisions are made collectively, considering all relevant perspectives.

At Brookdale, we facilitate care coordination with physicians and have relationships with preferred pharmacies to help prevent polypharmacy. To find out more about our approach to medication management, contact a Brookdale representative today.

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