Enhance Patient Well-being, Cut Costs: Advantages of Deprescribing

What is Deprescribing?

Deprescribing is a vital aspect of medication management aimed at optimizing medication regimens for better health outcomes and improved quality of life. The practice involves thoughtful reduction or discontinuation of medications that may no longer be necessary or beneficial. Here are five key benefits of effective deprescribing: 

1. Reduces Adverse Drug Events 

Adverse drug events (ADEs) refer to any harm experienced by a patient following exposure to a medication. These events can range from mild side effects to severe allergic reactions or even hospitalization. ADEs are more likely to occur in patients who are prescribed multiple medications, as the risk of drug interactions and adverse reactions increases with the number of drugs being taken. Deprescribing plays a crucial role in mitigating the risk of ADEs by carefully evaluating the necessity and safety of each medication in a patient's regimen. 

2. Improves Medication Adherence 

Medication adherence refers to the extent to which patients follow the instructions and recommendations provided by their healthcare providers regarding their medications. Adherence plays a crucial role in ensuring the effectiveness of treatment and achieving positive health outcomes. However, many patients–particularly those with multiple chronic conditions and complex medication regimens–struggle with sticking to their prescribed medications. This is where deprescribing can make a significant difference to simplifying medication regimens. Deprescribing can help simplify medication regimens by eliminating unnecessary medications, thereby making it easier for patients to understand and adhere to their medication routine.  

3. Managing Polypharmacy 

Polypharmacy refers to the use of multiple medications by an individual, typically involving five or more medications (1). While polypharmacy may be necessary to manage multiple health conditions, increasing patient medications can lead to various challenges and risks for patients. Deprescribing plays a crucial role in managing polypharmacy by reducing medication burden and minimizing potential drug interactions through the identification of potential interactions and elimination of medications that may interact negatively with others. This proactive approach helps prevent adverse effects, ensures medication safety, and optimizes medication regimens. 

4. Enhances Quality of Life 

In a study aimed at understanding the impact of polypharmacy on quality of life, researchers found patients taking at least 5 medications for chronic conditions had a lower health-related quality of life and a higher level of psychological distress (2). Polypharmacy may have a psychological impact as an increasing number of medications may make an individual feel dependent and less in control of their own health (3). In such cases, deprescribing can be employed as an approach to improving quality of life by reducing pill burden for patients. 

5. Promotes Collaborative Care 

Collaborative care is crucial for successful deprescribing efforts, as it involves the coordination of various healthcare professionals to optimize medication regimens. For example, pharmacist-led medication therapy management programs involve close collaboration with physicians to optimize prescribing patterns and reduce unnecessary medications. By promoting communication and coordination, deprescribing ensures that the combined insights of professionals contribute to a comprehensive understanding of a patient's needs. 

How Pharmacy Benefit Managers (PBMs) Can Facilitate Deprescribing 

PBMs can be instrumental in deprescribing medications because they are the repository of patient medication records. PBMs can deploy various strategies to facilitate deprescribing initiatives such as: conducting comprehensive medication reviews to pinpoint potential candidates for deprescribing, integrating clinical decision support tools to offer real-time guidance to healthcare providers, educating patients on the risks of polypharmacy and benefits of deprescribing, fostering collaboration among healthcare stakeholders, and implementing monitoring protocols for post-deprescribing follow-up. Through these methods, PBMs contribute significantly to promoting safe and efficient deprescribing practices, leading to enhanced patient outcomes and reduced healthcare expenditures. 

By Jasmine Zaidi, PharmD Candidate

For questions, e-mail pharmd@prodigyrx.com

Citations

1. American Geriatrics Society 2012 Beers Criteria Update Expert Panel. (2012). American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 60(4), 616–631. 

2. Van Wilder, L., Devleesschauwer, B., Clays, E., Pype, P., Vandepitte, S., & De Smedt, D. (2022). Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease. Preventing chronic disease, 19, E50.  

3. Palapinyo, S., Methaneethorn, J., & Leelakanok, N. (2021). Association between polypharmacy and depression: a systematic review and meta‐analysis. Journal of Pharmacy Practice and Research, 51(4), 280-299.