Polypharmacy is when a person is taking 5 or more medications.
There is a place for appropriate polypharmacy. However, it is important to identify inappropriate or problematic polypharmacy which can result in various complications such as increased side effects, falls, fractures, mental health symptoms, hospitalisation, overdose and death.
Deprescribing is the planned and supervised process of dose reduction or stopping of medication that might be causing harm, or no longer of benefit.
Deprescribing, as a term was initially used in the context of reducing medication burden in the elderly, but has since been expanded. Deprescribing antidepressant treatment has been a topic of much discussion.
Deprescribing is part of good prescribing and is much more than a tapering algorithm, especially in the context of polypharmacy. Therapeutic engagement, providing a trusting and safe environment, continuity of care, understanding the meaning patients attach to medications, exploring the patient’s recovery goals, and being flexible in the tapering regimen are crucial to an improved outcome with deprescribing in complex polypharmacy. Check out the resources page for further information.
It is not uncommon for patients with chronic pain to be prescribed a multitude of medications that have accumulated over time, including antidepressants, antipsychotics, and anticonvulsants. Employing the principles of deprescribing is beneficial in assisting patients to reduce their medication burdens, particularly when those medications may be doing more harm than good
At times, the reliance on medications such as opioid analgesics (e.g., Oxycodone, Codeine) and benzodiazepines (e.g., Diazepam, Alprazolam) may escalate into a substance use disorder, commonly referred to as addiction. These situation, particularly with opioid analgesics, might necessitate opioid pharmacotherapy or substitution therapy with agents such as Buprenorphine (e.g., SuboxoneTM, BuvidalTM, SublocadeTM) or Methadone.
More information coming soon.....