Implementing deprescription as a patient safety tool in primary care.

Jose-Miguel Bueno-Ortiz, Maria-Pilar Astier-Peña, Andrée Rochfort, Jose-Maria Valderas-Martínez, Joel Lehmann, Albina Zharkova, Sara Ares-Blanco, Ana Cebrian

Keywords: deprescription, deprescription, patient safety

Introduction:

The major aim of Deprescribing (D) is to purge the drug (s) considered inappropriate in a given patient, especially in the Elderly Patients (EP) with multiple comorbidities or in those suffering from chronic disease. Current guidelines have limited applicability to EP with comorbid conditions, the efficacy and safety of many drugs is unknown or questionable and there is evidence that taking more than ten drugs simultaneously cause adverse events. The differential diagnosis of any sign or symptom in the EP should always include the question "Could this be caused by a drug?". GP's role in promoting a safer use of medications in EP is paramount. However, in daily clinical practice, it is not easy to implement and sustain deprescribing over time

Method:

Target group: Front line Family Doctors
Didactic Method: Short theoretical introduction followed by small groups work on frequent clinical situations. Discussion, proposals and take-home messages for daily practice.

Results:

Objectives:
1) Introduce the concept of D and why it is important for patients and doctors;
2) Define the concepts of therapeutic cascades and D ascents;
3) Provide an overview of the evidence to stop unnecessary or potentially harmful medications and point out specifically good examples of common drugs which would be appropriate to D
4) Provide GPs resources to help to tackle these issues with EP and to empower them to consider D on a regular basis

Conclusions:

Very rewarding experience from the workshops run till now. Less time should be devoted to theory and more to day-to-day practical examples. Participants should be active most of the time.

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