BC Provincial Deprescribing Webinar Series #6

13 Mar 2024 BC Provincial Deprescribing Webinar Series #6

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Posted at 15:06h in Education, Podcasts & Videos by

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 hoped.  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 through our popular Deprescribing Webinar series initiated in February 2023.  Learning together, we hope to build confidence and knowledge about deprescribing in BC and beyond. This sixth session was held on Wednesday, March 13, 2024 – scroll down to view the video recording.

Over 2,500 participants signed up for at least one of the 6 Deprescribing Webinar sessions held to date. Links to the previous 5 sessions (links include the slide decks and video recording for each session):

DATE: Wednesday, March 13, 2024

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: Hallucinations from drug treatment for Parkinson’s disease

Presented by: Juan Maria Rubio Lopez MD, MSc (Gerontology), PhD candidate

Dr. Rubio Lopez is a primary care physician who directs the Martos Health Care Centre of the Servicio Andaluz de Salud in Jaén, Spain. He teaches medical and post-graduate students and is also a doctoral candidate in the Inter-University Health Sciences Program of the University of Jaén.

LEARNING OBJECTIVES:

By the end of this presentation, attendees will recognize that:

  1. New symptoms or signs after a change in medication may be adverse drug effects, and hence reversible.
  2. A crisis arising from one medication can be an opportunity for more comprehensive reassessment of drug therapy and for deprescribing.
  3. A primary care provider must sometimes overrule specialists who are unaware of a patient’s evolving condition.

Case 2: Patient-led Deprescribing

Presented by: Sadie Quintal, BScPharm, RPh, CDE

Sadie Quintal is a Primary Care Clinical Pharmacist working with the Comox Valley Primary Care Network of physicians and nurse practitioners on Vancouver Island, British Columbia. She has a background in hospital clinical pharmacy, but now works within prescribers’ offices to review patients with complex polypharmacy or suspected medication problems.

LEARNING OBJECTIVES:

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

  1. Develop an approach to collaborate with a patient and prescriber in the face of complex health issues, complicated polypharmacy, and potentially serious long-term adverse drug effects.
  2. Understand how a constructive approach may prove surprisingly helpful, in what at first appears an intractable problem.
  3. Appreciate that diplomacy and patient advocacy sometimes go hand in hand.

The BC Provincial Deprescribing Webinar series 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
Co-Chair, 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 2-3 months.  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.

2 Comments
  • Mike Izdebski
    Posted at 09:19h, 28 May Reply

    It is very heartening to learn about the existence of TI and that there is increasing interest in deprescribing. I took particular interest in the webinar with Dr. Mark Horowitz on May 8th 2024.

    Can anyone tell me how a patient in BC can gain access to a physician who is familiar with the hyperbolic tapering of antidepressants – and can support the patient safely discontinue long-term unproductive treatment.

    • Douglas Salzwedel
      Posted at 14:31h, 29 May Reply

      Any patient can ask their prescribing doctor or nurse practitioner (NP) to consider designing an appropriate schedule, with suitable follow-up appointments (virtual or in person). If the prescriber does not feel prepared to do this, we know of two alternatives that are widely available in British Columbia:

      1) Primary Care Network (PCN) Pharmacists in BC are employed by the Health Authorities (Vancouver Coastal, Fraser, Island, Interior, and Northern) to work with doctors and nurse practitioners to assist with medication reviews and deprescribing. You can ask your prescribing doctor or NP if they are able to request this free service from one of the PCN consulting pharmacists in your community or region.

      2) If your doctor, NP, or community pharmacist isn’t connected to a Primary Care Network, you can also contact your local Division of Family Practice (https://divisionsbc.ca/divisions-in-bc) directly and ask them for a referral to a PCN Pharmacist.

      PCN pharmacists specialize in medication review, and should be able to help you devise an appropriate tapering schedule and help to supervise the process.

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