Deprescribing Initiatives in Canada
Everywhere in Canada, patients, health providers and policy makers are making sure deprescribing is part of routine patient care. Check out these programs to learn more!
MedWise, University of Alberta, Faculty of Pharmacy and Pharmaceutical Sciences
The MedWise program focuses on empowering seniors about how to start a conversation with their pharmacists about their medications, potential benefits and harms, as well as non-drug alternatives to medications. Through MedWise, seniors are matches with pharmacy students, who help seniors boost their self-confidence and knowledge about medications through role-playing, group problem solving and sharing ideas/experiences.
University of British Columbia (UBC) Pharmacists Clinic
The Pharmacists Clinic at the University of British Columbia is where patients receive one on one time with an expert pharmacist to address their medication questions, demystify complex drug treatments and optimize their drug therapy outcomes. Most patients at the clinic take multiple drugs and want information and advice on what to continue, what to reduce or omit, and how to do this safely. Family physicians and specialists also refer patients when they are faced with a long medication list and need pharmacist input on services such as de-prescribing.
Pharmacist services are publicly funded and provided at no charge to patients either in-person (at the UBC Vancouver campus), in selected Lower Mainland medical offices, by telephone or by secure videoconference. The clinic primarily serves British Columbia, and some residents of other provinces/territories.
Care is focused on achieving the patient’s goals in collaboration with other members of the care team, including the patient’s local community pharmacist.
See the UBC Pharmacists Clinic website for more information or to request an appointment.
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Prairie Mountain Health (PMH) Sedative Deprescribing Initiative
This PMH Sedative Deprescribing Initiative focuses on educating people who take benzodiazepines about the risks associated with their use. This project aims to implement a client-centered deprescribing education program based on Choosing Wisely’s “Drowsy Without Feeling Lousy” toolkit. This program will share information with pharmacists, physicians and nurses in the PMH Region through department meetings, medication reviews and on-line resources.
NEWFOUNDLAND AND LABRADOR
Medication Therapy Services Clinic
The Medication Therapy Services Clinic, or MTS Clinic, is a “pharmacist-clinic” run by the School of Pharmacy at Memorial University. The clinic pharmacists see patients by appointment to provide in-depth medication assessments, and work with patients, their doctors and community pharmacists (and other health providers) to ensure they are taking the best medications for them, and using them in a way to ensure they are receiving the full benefit. Patients can be referred by their health provider or call themselves to book an appointment anytime. Visit the MTS Clinic website for more information.
North York Family Health Team’s insomnia reduction program focusing on elderly patients
After reviewing data from their electronic medical records showing that 10% of the 20,000 seniors in their patient population had been prescribed a sedative hypnotic drug, the North York Family Health Team (NYFHT) decided to put in place a quality improvement initiative. They arranged an insomnia reduction program for seniors with the intent to reduce the use of sedatives such as benzodiazepines.
This multi-disciplinary program was divided into two parts:
Firstly, a consultation with a pharmacist: an individualized assessment and recommendations for weaning off sedative hypnotic medications, with follow-up as needed;
Secondly, a group-based cognitive behavioural therapy for insomnia (CBT-I) program lasting seven weeks and facilitated by a social worker, pharmacist and dietitian.
Among participants completing the first part of the program, 75% successfully reduced their usage of sedative hypnotics, while 20% ceased completely. 79% of participants completing the second part of the program reported an improvement in sleep quality and mood.
This project was the 2017 recipient of the Association of Family Health Teams of Ontario’s Bright Lights Award for the category Clinical Innovations for Specific Populations!
Click here for contact information.
Agir pour mieux dormir program (available in French only)
The Agir pour mieux dormir program helps people over age 55 gradually reduce their sleeping pills and offers non-drug alternatives for insomnia. A pharmacist and nurse provide support through five group sessions (in groups of eight) to inform participants about sleep, insomnia and the risks of using sleeping pills. Private meetings with a pharmacist are also possible. This program is offered free of charge at the local community service center (CLSC) de la Haute-Ville.
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