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Behind the research

SaferMedsNL program digs deep into effects of deprescribing movement

Part of a special feature focusing on how the Memorial community is contributing to the direction of Newfoundland and Labrador.

By Heidi Wicks

Approximately 40 per cent of older Canadian adults have used a medication that was potentially harmful.

These medications cost Canadians over $419 million. The cost of treatment for the harms from these medications cost our health-care system an estimated $1.4 billion.

With SaferMedsNL, Memorial’s School of Pharmacy, the Université of Montréal, the Canadian Deprescribing Network (CaDeN) and the Department of Health and Community Services are making a change.

The provincial initiative aims to unite patient advocates, community organizations, health-care professionals and academic researchers to spark meaningful conversations between patients and health providers about their medication use, with the ultimate goal to improve medication use for patients and the health-care system through deprescribing.

Describing deprescribing

Dr. Debbie Kelly, an associate professor in the School of Pharmacy and director of the Medication Therapy Services (MTS) Clinic, is the project co-lead, alongside CaDeN’s Dr. Justin Turner, a research expert in the deprescribing movement.

Dr. Justin Turner
Photo: Rich Blenkinsopp

“Research shows that patient engagement is vital if we are going to improve medication use,” he said. “For example, consider the D-PRESCRIBE trial, which was published last year in the Journal of the American Medical Association.

“In that trial, pharmacists talked with patients and provided education about the risks and benefits of their medications,” he continued. “They also sent evidence-based pharmaceutical opinions to physicians to recommend deprescribing.”

The trial results showed that 43 per cent of seniors successfully discontinued their medications, compared to just 12 per cent in the control group.

SaferMedsNL hopes to see similar results in Newfoundland and Labrador, Dr. Turner says.

‘Why would we continue taking a medication that may be causing harm?’

Dr. Kelly says that SaferMedsNL focuses on three classes of medications: stomach medications for reflux and heartburn (PPIs), sleeping pills and opioid painkillers.

Newfoundland and Labrador has some of the highest use of these medications compared to the rest of Canada.

From left are Dr. Debbie Kelly, Dr. Justin Turner and Kelda Newport (project co-ordinator), who are leading SaferMedsNL.
Photo: Rich Blenkinsopp

“When the risks of any medication outweighs the benefits, they become potentially harmful or inappropriate for that person,” she said. The question then becomes, ‘Why would we continue to take a medication that we no longer need or may be causing harm?’”

By reducing the use of potentially harmful medications, SaferMedsNL hopes to reduce hospitalizations, falls and fractures and mortality associated with their use.

A cost-consequence model will be created to guide the sustainability of the initiative.

Empowered patient = powerful thing

The researchers also hope to ignite change in how medications are being prescribed and monitored across the province.

Dr. Kelly says their goal is to ask patients, “When was the last time you asked, ‘Do I still need this medication?’”

“We hope to decrease the use of potentially inappropriate or unnecessary medications, but most importantly we hope to empower patients to ask their pharmacist, doctor, or nurse about their medications. An empowered patient is a powerful thing.”

Dr. Debbie Kelly
Photo: Rich Blenkinsopp

Dr. Debbie Kelly

On Tuesday, March 19, as part of Pharmacist Awareness Month, Dr. Kelly will take over the School of Pharmacy’s Twitter account.

Be sure to follow @schoolofpharm to find out more about the research behind deprescribing and better patient care.

Follow SaferMedsNL on Twitter and Facebook.

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