“Deprescribing” Canadian seniors want to cut back on the drugs they’re taking

Researchers from the University of Montreal have found that many Canadian seniors are concerned that they’re taking too many prescription medications but few of them have the knowledge or awareness to speak to their doctors about the issue, a growing public health problem, say experts.

Canadians over the age of 65 take a lot of drugs. Two-thirds of seniors are currently taking more than five prescribed drugs every day, often to address a number of different health concerns and conditions. For those over the age of 80, two thirds are taking more than ten different drugs a day.

While physicians prescribe medications with the best intentions, and, in itself, there is nothing inherently wrong with taking many medications at the same time, if proper oversight is conducted, at the same time, there are identifiable harms that can result from what is known as polypharmacy. Too many prescriptions can produce an increased risk of adverse drug interactions or unnecessary or inappropriate prescriptions, not to mention an increased financial cost to the patient and health care system. Research has also shown that inappropriate prescribing and polypharmacy are associated with a higher risk in the elderly of falls, of experiencing adverse drug events, hospital admissions and even death.

The growing awareness of these dangers has led to the coining of a new term: deprescription, which refers to the process of taping off, stopping or discontinuing medications to improve overall health. Last year, the Canadian Deprescribing Network was launched in attempt to raise awareness about the issue and to support deprescription.

The amount of medications taken by seniors is “shockingly high,” says Barb Farrell, scientist with the Bruyère Research Institute in Ottawa and executive member of the Network. “We’ve got a four-year plan with a goal of reducing unnecessary or inappropriate medication use in older patients by 50 per cent by 2020,” she said to the Ottawa Citizen. “It’s a lofty goal, but we thought we might as well shoot high.”

As the new research shows, awareness of the problem is key. Researchers conducted phone surveys with 2,665 men and women over the age of 65 and found that while only seven per cent of those polled had heard of the term “deprescribing” before, 65 per cent said that they were aware that some medications can potentially be harmful to seniors and 41 per cent had spoken to their doctor about stopping certain medications. The survey also found that by a wide margin (about three-quarters of those polled), seniors are willing to stop one or more of their medications if their doctor says it’s possible.

The results speak to the need for more conversations between patients and physicians about deprescription, say the study’s authors.

“Many older adults remain uninformed about medication harms and do not question their prescriptions,” say the study’s authors. “It is likely that raising awareness of inappropriate medications and the concept of deprescribing will increase engagement of older adults in deprescribing conversations.”

The new study is published in the Journal of the American Geriatrics Society.

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