DocTalks: Reducing risks of medications for seniors

January 7, 2020

How to make deprescribing more like dancing than wrestling

Doctors of BC is pleased to introduce the first video in a new multimedia series called DocTalks — a series of videos and podcasts promoting dialogue on timely, relevant topics impacting the BC medical community—and the patients and families they care for.    

"Addressing Polypharmacy – New Habits for Effective Deprescribing,” created by the Shared Care Committee’s Polypharmacy Risk Reduction Initiative, features Dr Mark Lawrie, a family physician in Penticton with extensive experience in polypharmacy. In this 20-minute video, viewers will have the opportunity to learn habits and strategies adopted by Lawrie over the years to help mitigate the well-known risks of polypharmacy—confusion, delirium, falls, and other negative consequences—that can seriously impact a person’s quality of life, especially those who are elderly or frail. 

The video will be of interest to all involved in prescribing and deprescribing: physicians, residents, nurses, pharmacists, care staff, patients, families, caregivers and others. A supporting document has been created to take learning one step further; with resources, a case study, and reflective exercises to facilitate Group Sessions or ongoing individual development. 

WATCH: Access the video and supporting document here

In the video, Lawrie shares his approach through telling Edna’s story—a case study of an elderly woman on multiple medications whose deteriorating health has meant her loss of independence. Lawrie likens his role to a “suspicious detective” as he reviews Edna’s medications to determine if polypharmacy could be responsible for her decline. Lawrie also describes looking for clues to assess which drugs may be causing more harm than benefit, and how he ranks drugs to develop a medication plan to stop, taper, or substitute the culprits potentially causing adverse reactions and drug cascades. 

Lawrie emphasizes the importance of collaboration and good communication between the care team, patients, families and caregivers around medication deprescribing. Frequent, honest conversations about goals of care, and the wants and needs of an individual for best quality of life, make the process of deprescribing like “dancing rather than wrestling” states Lawrie.  

About Dr Lawrie

Lawrie’s interest, skills and strategies for effective deprescribing grew through his involvement in a long term care initiative facilitated through his local Division of Family Practice, and his participation in the polypharmacy risk reduction component of the initiative supported by the Shared Care Committee (a Joint Collaborative Committee of Doctors of BC and the BC government). Eventually Lawrie shifted from learner, to mentor and educator, and the past years have seen him mentoring local physicians, providing medical education/CME sessions in hospitals and universities, and speaking at conferences.