At Nazareth Home, we offer a holistic approach to care, including incorporating healthy diets, appropriate exercise, and therapy to enhance overall well-being. Another piece of this approach is also regularly looking at residents’ medications to reduce inappropriate polypharmacy. 

Polypharmacy, defined as the regular use of at least five medications, can pose serious risks to some patients. Deprescribing aims to combat these risks by reducing or eliminating unnecessary medications for the patient. 

According to a 2019 study published in American Family Physician by Anne D. Halli-Tierney, M.D., Catherine Scarbrough, M.D., M.Sc, and Dana Carroll, PharmD, polypharmacy is most-recognized in older adults because patients with more than one chronic condition often have more extensive medication lists. Because older adults are so often prone to polypharmacy, the effects are commonly seen at nursing homes and assisted living facilities. According to the study, up to 91 percent of patients in long-term care take at least five medications daily. 

Medical professionals at Nazareth Home take the time to examine cases of polypharmacy among elders and communicate with them and their families about deprescribing options. 

“Providing the best care for each elder means that we need to regularly review their medications,” Nazareth Home Medical Director Bonnie Lazor, M.D., said. “Maybe the answer doesn’t lie in medication, but a change to the elder’s dietary regimen may help alleviate their symptoms. These are things we look at.”

These efforts can prove to be very important due to the risk factors associated with polypharmacy. According to the American Family Physician study, negative consequences of polypharmacy can include decreased quality of life, increased mobility issues, increased mortality, financial stress, falls and more. Depending on the patient, deprescribing can help alleviate these issues and sometimes lead to clearer cognition for patients.

According to the American Family Physician study, considerations for deprescribing may include:

• • • The patient’s medical history
    • Their full medication list
    • Appropriate dosing
    • Their prescribed drug’s interaction with other drugs, foods and illnesses
    • Their goals/the goals of their caregiver
    • Consumer options for lowering drug costs and more. 

“The goal is to understand which medicines give them quality of life,” Dr. Lazor said. “Those that aren’t really helping the elder should be considered for deprescribing. At the end of the day, we have to look at balance and side effects as well.”

At Nazareth Home, deprescribing efforts are being supported by the medical team’s consultant pharmacist, who assists in identifying potential medications to wean or eliminate. When it comes to approaching deprescribing at Nazareth Home, Dr. Lazor said thorough communication with the families of elders is of utmost importance. 

“We involve the family in the decision,” Dr. Lazor said. “We want to help them understand polypharmacy and the potential benefits of deprescribing.”