Sydney Springer, University of New England – Working with Doctors on Deprescribing
On University of New England Week: Medications doesn’t come without risks and side effects.
Sydney Springer, assistant professor of pharmacy, explains why some would rather go on without them.
Dr. Springer is a preceptor for Advance Pharmacy Practice Experience (APPE) students in Ambulatory Care. She works in family practice at Mid Coast Medical Group – Family Practice Parkview in Brunswick, ME. She works closely with providers, nurses, medical assistants and social workers to coordinate care for community dwelling patients – with a focus on geriatrics, polypharmacy, and deprescribing.
Working with Doctors on Deprescribing
In a small study a student and I conducted in 2021, we found that an overwhelming portion of participating older adult community dwelling Mainers were interested in deprescribing. Deprescribing is the supervised process of stopped or reducing medications, where the risk of a medication outweighs the benefit of continuing it. Deprescribing is aimed at reducing medications that place patients at risk. Those with a large number of medications, known as “polypharmacy” are more likely to be on inappropriate medications, have more drug interactions, and experience more emergency department visits and hospitalizations.
In our study, 84 percent of survey participants indicated that they would be interested in stopping one or more of their medications if their provider said it was possible. In this survey we also found that about a third of participants were interested in stopping a medication to see how they felt about it, about a third indicated they felt like they would be missing out on future benefits if they stopped their medications, and about a third would be reluctant to stop their medications that they had been taking for a long time. Almost everyone disagreed that if a provider stopped their medication, they would feel that their doctor was giving up on them. This study tells us that as providers—physicians, nurse practitioners, physician assistants, and even pharmacists in some states—we have the potential to educate our patients about appropriate medications. We can educate about the likely limited long-term benefits of some medications, and the harms of others. Our patients have a lot of faith in us as medical experts, and are ready to discuss deprescribing as a part of their healthcare experience.
Dear Dr. Springer,
I heard your academic minute on deprescribing this week on WAMC. I found it compelling, except for one omission. The constant drug advertising on TV, the “call your doctor,” “tell your doctor,” etc., often more than half the commercials, always with smiling, happy people while the voice-over details some deadly side effects. I can remember when drug advertising was not allowed on TV, although tobacco advertising was nonstop. Just a thought. Regards, Jerry Kleiner