Deprescribing as important as prescribing
A research team at the Bruyère Research Institute is developing guidelines to help health professionals and patients navigate through the complex concept of deprescribing. Deprescribing means safely reducing or stopping medications.
Barbara Farrell, PharmD, is the co-lead of the Deprescribing project. She is an investigator at the Bruyère Research Institute and a pharmacist in the John and Jennifer Ruddy Geriatric Day Hospital at Bruyère Continuing Care. Many patients at the Day Hospital are taking multiple medications. Barbara works closely with the patients and the Day Hospital physicians to reduce or stop medications that are no longer needed or may be causing harm.
Health care professionals have often lamented that clinical guidelines never include information about when it’s appropriate to stop a drug or how to do it safely. Barbara and her research team used rigorous methods to develop and test drug deprescribing guidelines that can be used in practice.
These guidelines address a number of questions such as when is it safe to reduce or stop medications? When could a medication be causing more harm than benefit? How should deprescribing be done?
The Deprescribing research team tested three guidelines at six sites in Ottawa over the last three years. The team also started publishing summaries of their guidelines on their website and submitted their guidelines for publication. Their work has been positively received across Canada and internationally. The Institute for Health Care Improvement and the Commonwealth Fund in the USA selected this project as a key health care innovation. Use of the guidelines in various US settings is also being explored. Barbara has also been involved in establishing the Canadian Deprescribing Network (CaDeN).