Deprescribing is defined as ‘the process of withdrawal of an inappropriate medication under supervision by a healthcare professional with the goal of managing polypharmacy and improving health outcomes’.
After reading this article, pharmacists should be able to:
Competencies (2016) addressed: 3.1.1, 3.1.2, 3.1.3, 3.2.2, 3.3.1, 3.3.2, 3.5.1, 3.5.2.
Competencies (2010) addressed: 4.2.1, 4.2.2, 4.2.3, 6.1.1, 6.1.2, 7.1.1, 7.1.2, 7.1.3, 7.2.1, 7.2.2, 7.2.3, 7.3.1.
You have been asked to complete a Home Medicines Review for Joanna, an 80-year-old woman. Her medical history reveals that over the past two years she has had a gradual decline in her cognitive function, primarily manifesting as difficulty with names and memory impairment. Three months ago, Joanna started risperidone 0.5 mg twice daily because of increased agitation and nocturnal wandering.
Joanna recently had a visit to the emergency department of a local hospital for an injury from a fall. This was due to a pre-syncopal episode at home, and resulted in a fracture. No underlying cardiac or neurological event was identified as the cause of the fall. The fracture was treated conservatively, and she was discharged with tramadol 50 mg capsules. Directions were to take one capsule four times daily as needed.
Joanna’s medical history includes insomnia, hypertension and depression. Her current medicines are:
Joanna is cared for by her daughter Natalie, who lives with her. Natalie works evenings three days per week and on those nights Joanna is at home by herself.
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