Less is more when it comes to medication: consultant pharmacist
Not all medications do what they should — so how do you know if yours are working?
Mathilda Prinsloo is a consultant pharmacist with her own practice, Patient Care and Thrive. She has training in geriatrics, diabetes and cognitive behaviour therapy, focusing widely on medication management and deprescribing — a new science in medicine.
Prinsloo brought her presentation on deprescribing to the Lions Manor last week, teaching community members about the new process she works through with her own patients. The presentation was put on by the South Interlake Seniors Resource Council (SISRC), which offers educational and health presentations once a month in the Lions Manor multi-purpose room. The presentations are free for all community members to attend.
Prinsloo relates deprescribing medications to decluttering, downsizing or simplifying them. While the practice is fairly new, it is evidence and science-based, and Prinsloo has proof it’s worth it.
Deprescribing is a process that mostly focuses on seniors who have numerous medications to keep up with.
Prinsloo said a lot of the time, people will be on medications that don’t offer them any benefits. A 2021 report Prinsloo referenced found one in four people over 65 have been prescribed more than 10 classes of medications, something she sees often.
“With aging people, they look for help,” she said. “Some people don’t realize what’s happening to them is quite normal.”
When on a lot of medications, sometimes the unnecessary ones can hinder the efficacy of the necessary ones. A lot of the time, people will also stop taking the medications they need but continue taking the ones they don’t because it’s simply too much to keep up with or too expen-sive for them, Prinsloo said.
Taking unnecessary medications could also be from a misdiagnosis.
Prinsloo had a patient with a misdiagnosis, whose medication was doing nothing for him. By deprescribing it, they were able to get him the proper diagnosis and proper medication he needed for the condition, she said.
So, Prinsloo works with these people to find which medications work for them and which ones don’t.
Starting with their medical history, she’ll go over everything with the patient, including every single thing they put in or on their body — even herbal remedies, supplements, over the counter drugs and topical treatments.
“You need to take it all into account and look at the patient holistically,” Prinsloo said.
She reviews each medication and asks the patient why they’re on them. Sometimes, they don’t know, so she’ll work with their doctor to find out why, and if they feel the medication might not be necessary, they’ll start tapering the dosage of it. If nothing happens, they’ll taper it more and more until it’s obvious the patient doesn’t need the medication.
That process is how Prinsloo helps to deprescribe medications for people. Her presentation last week was titled, “What Was Good in the Past May Not Be Good Now,” with the main takeaway being for people to ask their prescribers why they take each medication they’re on.
Taking unnecessary medications can lead to two main adverse reactions: memory loss and falling.
In Manitoba, 3,000 seniors die each year due to adverse drug events, with 88 per cent of them being preventable — this includes falling, accidents in the home, motor vehicle accidents, bleeding and delirium.
According to the Canadian Institute for Health Information (CIHI), seniors in Canada are hospitalized five times more than people under 65 due to medication-related issues. And each year, the Canadian government spends around $1.4 billion on healthcare costs to treat the harmful effects of medications.
Prinsloo believes these statistics could be much lower with the practice of deprescribing.
SISRC offers services for seniors and those with disabilities to help them remain independent, safe, and comfortable in their own homes. For more information on SISRC, call (204) 467-2719.
