Talking About Medications
Starting a conversation about one’s care is vital to anyone’s health. Yet when it comes to using multiple medications, known as polypharmacy, many older people do not feel confident or equipped to raise questions with their health care providers. This is important to address since polypharmacy can contribute to additive side effects and drug interactions, falls, cognitive impairment, functional decline and even emergency room visits and hospitalizations.
Deprescribing is an approach to addressing problems with using multiple medications. It involves health care providers working with patients to reduce the dose or stop medications that may be causing more harm than good or are no longer providing benefit. Making joint medication decisions between patients and health care providers, also known as shared decision making, is increasingly important in combatting problems associated with polypharmacy.
A caregiver for a loved one in long-term care shared that “three workshops over three weeks were helpful, I got to try things out, and then get help with any barriers or difficulties that I encountered. The length of each workshop was ideal as well. You've hit the workshop Goldilocks zone in terms of frequency and length.”
“The workshop is already being delivered by health care providers in other parts of Ontario and in the United States,” said Barbara Farrell, PharmD and lead investigator of Bruyère Research Institute’s Deprescribing Research Team, “and based on our post-workshop surveys, we’re hearing that participants feel their confidence in speaking with their providers has increased. It’s a great example of how research here at Bruyère impacts care, not only for our patients and community, but for patients worldwide.”
They also shared that the interactive style of the workshop and the facilitator’s willingness to give examples from personal experience made it easier for participants to share their own experiences, while the practical tips on where to get information were one of the most valuable aspects of the session.
“This workshop helps to better educate the public about polypharmacy and learn how to steer away from it,” shared another participant. “It also shows how important it is for individuals to learn how to advocate for themselves (or for someone in their care). With these types of workshops, individuals can learn to be assertive, curious, confident and competent about their health.”
Participants also appreciated how it was accessible to those outside of the medical field. “What to communicate to the medical professionals is just as important as to how to communicate with them. The workbook was an excellent support and resource,” one participant said.
The roll out of this series has highlighted the vital role that pharmacists and health care providers can play as educators. The workshop, originally designed primarily for older adults, has grown to encompass caregivers and long-term care professionals in its audience. Ensuring this program remains open access for use by pharmacists and health care providers in the community and around the world is an important part of the deprescribing research team’s priority in driving international impact. Health care providers from five other countries have already attended training webinars to learn how to implement the series for their patients.
Their experiences with community engagement and workshop implementation were published in the Journal of Community Engagement and Scholarship and Canadian Pharmacists Journal respectively, and their workshop materials remain available on the Deprescribing website.
The development of this workshop was supported in part by the Government of Ontario HSRF grant, the Centre for Aging and Brain Health Innovation (CABHI) SPARK grant, and funded in partnership with the Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère. Talking About Medications has been facilitated by four Bruyère pharmacists, Jasprit Dhaliwal, Angel Deng, Ida Famiyeh, and Lisa Richardson with the support of Tammie Quast, Sameera Toenjes, and Dan Dilliott.