BC Provincial Deprescribing Webinar Series #4

20 Sep 2023 BC Provincial Deprescribing Webinar Series #4

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. This was the fourth session, which took place on Wednesday, September 20, 2023.

Links to the previous sessions in the Deprescribing Webinar series (links include the slide decks and video recording for each session):

• February 8, 2023: BC Provincial Deprescribing Series Webinar #1
• April 19, 2023: BC Provincial Deprescribing Webinar Series #2 
• June 14, 2023: BC Provincial Deprescribing Webinar Series #3

DATE: Wednesday, September 20, 2023

TIME: 12:00 – 13:00 Pacific Time convert to your local time

WHERE: This was a free virtual event.

CME CREDITS: MainPro+/MOC Section 1 credits: 1.0. Those who register, attend the webinar and complete the evaluation will receive their certificate.

LEARNING OBJECTIVES

By the end of the presentation, attendees will be able to

1. Recognize when a medication list is not appropriate for a patient’s long-term health
2. Begin to develop a plan to simplify by deprescribing potentially harmful or redundant drugs.
3. Identify helpful collaborators (pharmacists, specialists, or other colleagues) who can assist with successful deprescribing

Case 1: “Cocktails” of psychotropic drugs in a refractory mental health patient – a collaborative approach to simplify her medication regimen

Presented by: Angela Tong, BScPharm, ACPR

Angela Tong is a Fraser Health Authority clinical pharmacist. She completed her Accredited Canadian Pharmacy Residency at Lower Mainland Pharmacy Services and is an experienced UBC Pharmaceutical Sciences Clinical Instructor. She specializes in optimizing therapeutic outcomes in persons diagnosed with complex, refractory mental health and substance use disorders. She works collaboratively with the interdisciplinary team to help mental health patients on their roads to recovery. She advocates for patient-centered care and demonstrates her enthusiasm and passion in teaching by sharing her clinical experience with learners and fostering them during their experiential practicums.

She believes that the pharmacist serves a fundamental role in rationalizing medication regimen and de-prescribing after witnessing vulnerable patients suffer from preventable adverse events related to medications. Outside of professional life, Angela enjoys traveling with her husband and two children to Asia to experience the Chinese culture and lifestyle.

Case 2: A patient’s request for deprescribing when there are multiple specialists – shared decision making in the patient’s medical home

Presented by: Trudy Huyghebaert, PharmD, BSc Pharm, CDE, ACPR, APA

Trudy Huyghebaert is the clinical pharmacist for the Department of Family Medicine Teaching Clinics at the University of Calgary/Alberta Health Services.  She received her Doctor of Pharmacy from Idaho State University and graduated with Honors, undergraduate pharmacy degree at the University of Alberta and completed a hospital residency at the Ottawa Hospital.

Clinical areas of interest are evidence-based medicine, sustainable healthcare and chronic disease management in primary care (with a special interest in Diabetes and Chronic pain).  Trudy strives to incorporate shared decision-making using evidence-based medicine with her patients.

Outside of work, she can be found scuba diving in the Alberta mountain lakes in the summer, running in Fish Creek Park or spending time with her two daughters (12 and 16) and their crazy labradoodle, Bailey.

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.