Deprescribing-What is it?

I watched an interesting presentation about deprescribing. Deprescribing is the process of stopping medications that are no longer needed. Medications can be indicated for a certain disease at a certain time. Sometimes, these medications get renewed when they are no longer needed.

The presentation talked about prescribing cascades. This happens when a medication causes a side effect. The side effect is looked upon as a new disease that needs to be treated. Then, another side effect happens with this new medication and another medication gets prescribed. This process could happen over a period of weeks to months to years. For example, a person injures their knee and gets prescribed Advil or Motrin (ibuprofen). The ibuprofen increases blood pressure. Now, a blood pressure medication like amlodipine (Norvasc) gets prescribed. The amlodipine causes ankle swelling. Furosemide (Lasix) is added to treat the ankle swelling. Furosemide lowers potassium and a potassium supplement is needed. Furosemide also causes incontinence and a medication like oxybutynin is needed. Thus, five medications result because ibuprofen was prescribed. This cascade could have been avoided by prescribing Tylenol (acetaminophen) in the first place! However, the length of time that has elapsed makes it more difficult to detect. This type of experience is common in older adults.

Lifestyle medicine prevents prescribing cascades by getting at the root cause of disease. This is the work that I do. I help guide people to health and eliminate unnecessary medications. Thanks for reading! #lifestylemedicine

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