19 Apr 2023 BC Provincial Deprescribing Webinar Series #2
This live webinar has already taken place. Scroll down to view the video recording.
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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 and almost 800 people registered for the inaugural webinar in this new series and those who attended rated the event highly. The second session was held on April 19, 2023 with almost 500 people registered. The third webinar in these series is scheduled for Wednesday, June 14, 2023.
DATE: Wednesday, April 19, 2023
TIME: 12:00 – 13:00 Pacific Time convert to your local time
WHERE: This is a free virtual event.
CME CREDITS: MainPro+/MOC Section 1 credits: 1.0. Those who registered, attended the webinar and completed the evaluation will receive their certificate.
Case #1: “Tapering Trial and Errors: A Pharmacist’s Perspective
Pharmacists are frequently involved in the care of patients with polypharmacy, and can typically identify a number of strategies to optimize a medication regimen, including deprescribing. Difficulties arise when medications are started by multiple different prescribers and when there is resistance to changing treatments that were prescribed by a specialist, even when they may no longer be working for the patient.
There can be further challenges when a patient’s preferences and goals of therapy do not align with a specialist’s approach or with evidence-based guidelines. This case highlights nuances of deprescribing effectively and safely in primary care, while preserving relationships and interprofessional collaboration.
Case #2: “Deprescribing nearing End of Life: How Partnership and Shared Care Goals Play a Role”
The purpose of the presentation is to share details about a frail older adult at the latter stages of life on multiple medications with uncertain benefit. Then to demonstrate after establishing care goals with the person and with family partnership, deprescribing can be more meaningful when consistent with shared care goals.
LEARNING OBJECTIVES
By the end of the presentation, attendees will be able to
- Recognize when a medication list is not appropriate for a patient’s long-term health
- Begin to develop a plan to simplify by deprescribing potentially harmful or redundant drugs.
- Identify helpful collaborators (pharmacists, specialists, or other colleagues) who can assist with successful deprescribing
Presenter Bios
Dr. Nikki Domanski a clinical pharmacist at UBC Pharmacists Clinic and is actively involved in patient care. She has a particular interest in team-based primary care and her current research is focused on documentation best practices for pharmacists. Nikki is passionate about teaching, shared decision making and interdisciplinary collaboration. Nikki completed her undergraduate and professional PharmD training at the University of Waterloo (Ontario) and is the first graduate of the accredited University of Waterloo/Centre for Family Medicine Ambulatory Care Residency program.
Dr Shirley Samuel-Haynes MD CCFP (COE) is a family physician with care of the elderly certification. She enjoys working with older adults with complex medical conditions along with their caregivers towards the later stages of their life. She lately finds all around satisfaction when addressing their diagnoses with a palliative approach to care. After the serious illness conversation, she thinks deprescribing naturally follows.
The BC Provincial Deprescribing Webinars are coordinated by:
Tom Perry MD, FRCPC
Clinical Associate Professor, Department of AP&T, UBC
Co-Chair, Education Working Group, UBC Therapeutics Initiative
tom.perry@ubc.ca
Wade Thompson PharmD, PhD
Assistant Professor, Department of AP&T, UBC
Organizer, International Deprescribing Conference
Education Working Group, UBC Therapeutics Initiative
wade.thompson@ubc.ca
INVITATION TO SUBMIT & PRESENT A CASE AT FUTURE WEBINARS!
Please let colleagues or friends know about this new webinar series.
- We host a 1-hour case-based webinar every 2 months (except August). The initial schedule is 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 are 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.
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.
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