Your activity: 6 p.v.

Points for communication about deprescribing

Points for communication about deprescribing
Communication with patients (and caregivers/family) to inform deprescribing
  • Obtain information about experiences with medications (side effects, effectiveness), preferences, and goals of care
  • Discuss realistic treatment goals – what do they value the most?
  • Elicit fears about deprescribing
Communication with patients (and caregivers/family) to achieve shared decision-making about deprescribing Why?
  • Discuss why deprescribing of specific medications is being recommended – lack of benefits, risk of harm, etc (tailored to the individual and their goals of care)
  • Frame as "not giving up on you" but as optimizing care
  • Explain that we may not have good evidence on the benefits and harms of medicines after long-term use
How?
  • Frame deprescribing as a trial, with reassurance that the medication(s) can be restarted if necessary
  • Offer alternative strategies to control bothersome symptoms
  • Plan tapering/withdrawal process
  • Discuss monitoring plan
Fears:
  • Attend to emotion
  • Explore and address fears and concerns about deprescribing
  • Discuss what to do if symptoms occur (monitoring plan)
Communication with other health care professionals
  • Activate patient to be custodian of medication list (but responsibility should not be solely placed on the patient)
  • Communicate plan clearly to other clinicians
  • Collaborate with other clinicians
    • Don’t be afraid of stopping/making a recommendation about stopping a medication that is determined to be inappropriate
    • Avoid devolving of responsibility – don't expect others to take responsibility for proactive deprescribing
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