Are there medications one can get “deprescribed”?Dr. Veita Bland / October 6, 2017
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Each and every day that I practice medicine I see patients who do not take their medication. For sure there are many different reasons for this to happen.
So many times we hear patients cite financial reasons for not taking the medications. A medication that was affordable when started has now been put on the unaffordable list by their insurance company. There are the cases where the medication was never affordable but was needed and then circumstances change and it cannot be bought by the patient.
There are the cases when people do not remember to take their medications. Now I divide that group into those who may be having memory problems and those who choose not to remember. For those with memory problems, we try to put into place people or alarms to help them remember to take their medication. For those who choose not to take their medications, we try to find out why. Is there a side effect such as a bad taste in the mouth, dizziness or impotence? We can try to find medications that can work around those problems.
For that group that refuses to believe they need their medications, I can only hope that my prodding helps to coax them before it is too late. Too late refers to having a stroke, heart attack or other irreversible consequence of not caring for a problem.
So my life has been trying to get patients to take their medication. Some patients want to know if they can get off medications or combine medications to decrease their pill burden. We know that as people get older and develop chronic diseases such as hypertension, diabetes, heart disease and lung disease, the number of pills they are taking will increase. A recent study showed that over 56 percent of Americans over the age of 65 were taking four or more medications.
Recently we have been seeing a push especially in the elderly to see if these medications are all needed. Examples would be that a medication was started 30 years ago by a doctor that has since retired and the new doctor does not know why the patient is on that medication but is afraid to stop it for fear of harm. There may be a medication that was started years ago when the kidneys could handle the medication but with age and decreased kidney function the medication is no longer safely handled by that person’s body.
As people age, we see problems with falls, hospitalizations, impaired physical and mental problems. Such conditions can be exacerbated by their medications.
In the elderly in particular we are using the term deprescribing. Here we actively look at the medications they may be on and thoughtfully see what we can stop or decrease the dosage in order to prevent or stop adverse events.
This I do with all my patients. It may be time to ask your healthcare provider if there are medications you can be deprescribed.
Dr. Veita Bland is a board certified Greensboro physician and hypertension specialist. Dr. Bland’s radio show, “It’s a Matter of Your Health,” can be heard live on Wednesdays, 5:30 p.m. on North Carolina A&T State University’s WNAA, 90.1 FM. Listeners may call in and ask questions. The show is replayed on Sirius 142 at 5 p.m. on Wednesdays. Email Dr. Bland at firstname.lastname@example.org.