08 Feb 2023 BC Provincial Deprescribing Series Webinar #1: It’s about time!
When challenged by complex cases involving people taking too many medications, we may ask:
- Can I stop any of these?
- Which should I stop first?
- Do I need to taper this drug? If so, how?
- What should I monitor for after stopping, and when?
Many clinicians address these clinical questions successfully, improving outcomes for patients. Sometimes, things don’t work out as we hope. At the Therapeutics Initiative, we want to create a platform for healthcare providers, patients, caregivers, advocates and policy makers to learn from each other about successes and challenges in deprescribing. Learning together, we hope to build confidence and knowledge about deprescribing in BC and beyond.
We launched a new BC Provincial Deprescribing Webinar Series (offered by Zoom) on February 8, 2023 from 12:00-13:00 h Pacific time. (click here to convert to your local time). Almost 800 people registered for the inaugural webinar in this new series and those who attended rated the event highly. The video recording of this webinar will be posted here soon. You can view the slides from this webinar by clicking on the DOWNLOAD button. Please let colleagues or friends know about this new webinar series.
- We will host a 1-hour case-based webinar every 2 months (except August) starting February 8, 2023. The initial schedule will be Wednesdays at 12:00-13:00 h Pacific Time, but we may vary this in future, depending on demand.
- Deprescribing Webinars are open to pharmacists, doctors, nurse practitioners, nurses, health profession students, patients & care providers, and others in health care who are interested in how to address undesirable polypharmacy effectively through responsible deprescribing.
- The Webinars will be case-based. We invite case submissions from any health profession (including students, and potentially from patients/caregivers who wish to share their experiences). As in any health care setting, we expect our audience to respect the confidentiality of information presented with informed patient consent. If you are interested to present a case of your own, see below.
The February 8, 2023 inaugural BC Provincial Deprescribing Webinars presented 2 cases:
The presenting family doctor writes:
“Do you have patients taking multiple high dose psychiatric medications who are no longer followed by a psychiatrist? Do you feel uncomfortable with their medication regimen and wonder how to safely deprescribe? Dr. Jill Norris (family doctor) and Dr. Alison Gregson (psychiatrist) will present a patient case that addresses some challenges to deprescribing psychiatric medications that family doctors face. The case highlights the potential for rapid deprescribing, ad hoc collaboration with a consulting inpatient psychiatrist, and the contributions of the community pharmacist. We will also discuss benefits and challenges of rapid deprescribing, and ongoing challenges to address this patient’s future mental health.”
Our presenting primary care clinical pharmacist writes:
“Adverse drug effects reported from clinical trials and in drug monographs typically reflect experiences with a single drug, given to reasonably healthy people. In real world clinical practice, our perspective is often very different. What happens when we mix multiple medications with overlapping effects that target many neurotransmitters, in a patient with a complex history? To what do we attribute observed problems that are almost certainly multifactorial? Is there a logical approach to tapering or stopping drugs in this scenario? How, and by whom, are changes initiated and communicated? I hope this case sparks debate on how to approach this complicated challenge constructively.”
The BC Provincial Deprescribing Webinars is coordinated by:
Tom Perry MD, FRCPC
Clinical Associate Professor, Department of AP&T, UBC
Co-Chair, Education Working Group, UBC Therapeutics Initiative
Wade Thompson PharmD, PhD
Assistant Professor, Department of AP&T, UBC
Organizer, International Deprescribing Conference
Education Working Group, UBC Therapeutics Initiative
INVITATION TO SUBMIT & PRESENT A CASE AT FUTURE WEBINARS!
Who should submit?
- Nursing, psych nursing, NP, medical, and pharmacy students or residents;
- Recently qualified practitioners working in hospital, community, or long-term care who identify a deprescribing problem or success they think will interest others;
- Senior clinicians in any health care field who want to share their acumen and experience with deprescribing clinical logic, pharmacokinetics, avoiding withdrawal, teaching others how to deprescribe successfully, use of electronic aides or AI;
- Patients or families who think their story may enlighten health professionals.
What will you need to submit a case?
- Patient consent to present anonymized relevant history, physical findings, drug list;
- Consent of your supervisor if relevant (e.g. students/residents);
- Obtain key details including all medications and doses, relevant vital signs (e.g.supine & standing BP and HR, RR and SaO2) while you have authorized access to patient record.
If interested, please contact Dr. Perry or Dr. Thompson at the emails above. We will work with submitters to develop succinct, effective presentations that allow time for audience discussion in Zoom Chat, Q&A, and through our moderators. If you wish to propose a case, don’t be shy! DO respect patient privacy – don’t disclose any information that could identify an individual. Dr. Perry can discuss possible case presentations by telephone, if you email him.