‘Could these medicines be doing more harm than good?’

Deprescribing Action Week has begun, with a host of medical groups looking to drive conversations around discontinuing medicines that are no longer required, or for which the risk of harm outweighs the benefits in the individual.
 
This year’s theme – Ask because you care – is designed to empower older Australians, those living with a disability, and carers to ask health professionals, ‘Could any of these medicines be doing more harm than good?’
 
The RACGP is one of eight medical and aged care organisations participating in the awareness week, which is specifically highlighting that psychotropic medicine is often overused to control challenging behaviours in older people and those living with a disability.
 
The Society of Hospital Pharmacists of Australia is leading the campaign, with President Tom Simpson describing polypharmacy and inappropriate medicine use as barriers to ensuring the safe and quality use of medicines in aged care and disability settings.
 
‘Several studies have demonstrated that challenging behaviours, particularly those seen in patients with dementia, are too often addressed by starting psychotropic medicines without first attempting to use evidence-based non-pharmacological interventions,’ he said.
 
‘It has been estimated that only 10% of antipsychotic medications and benzodiazepines … used in residential aged care are clinically justified, while an Australian study of adults with intellectual disability showed 82% were inappropriately prescribed psychotropic medicines.’
 
He also pointed out that around 250,000 Australians are admitted to hospital each year due to medication-related issues, many of which are preventable.
 
RACGP President Dr Nicole Higgins also backed the campaign, but noted that prescribing – and deprescribing – are complex areas of medicine that require careful management.
 
‘The goal of deprescribing is to improve a person’s quality of life by reducing the amounts and types of medicines to reduce the risks of complications such as falls and cognitive impairment,’ she said.
 
‘There are many other strategies that we have to assist people with behavioural challenges before we reach for the prescription pad. This is a complex area and there is no single solution.’
 
COTA Australia CEO Pat Sparrow also picked up on this theme, saying the awareness week is not about ‘stopping medication’, but ensuring prescribers and patients have the balance right.
 
‘It’s crucial that older Australians are supported to have conversations about reviewing, reducing or discontinuing their medicines,’ she said.
 
‘We need a system that places patients at the centre of the conversation through safer, shared decision making, and sees patients, pharmacists, doctors and nurses all working together in the best interests of the patient.’
 
Deprescribing Action Week will run until 24 March, with more information and resources available online.
 
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