Undoing what we ’ve done: Why deprescribing is so difficult

A guest column by the American College of Physicians, exclusive to KevinMD.com. I recently saw a 74-year-old patient to establish ongoing care. In reviewing her medical history, she presented me with the list of the 15 medications she was taking. I was a bit shocked given her medical history which really consisted of only the “usual” issues commonly seen in her age range, including hypertension, hyperlipidemia, and osteoarthritis. But she had no complex medical conditions for which a larger number of medications would be expected. She also did not seem like someone who would actively seek out overly aggressive medical care, particularly since one of her first questions to me was whether she really needed to take all of these drugs. She explained that she has trouble keeping her medication dosing schedules straight (“it seems as though all I do is take medicine”), she dislikes the way some of them make her feel, and the money she is spending on copays has a real impact on her fixed income. And to top it off, at least two of her medications were straight off the Beers list. Most of us are keenly aware that many patients are taking either too many drugs or are taking medications that either may not be of benefit or might actually be harmful to them. Surveys show that over half of individuals older than 65 years in the U.S. take four or more prescription drugs, and that upwards of 30% of these patients may be taking at least one that is potentially inappropriate. Continue...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician American College of Physicians Geriatrics Primary Care Source Type: blogs