Using Community Engagement to Initiate Conversations About Medication Management and Deprescribing in Primary Care

Abstract

Polypharmacy, or the simultaneous use of multiple medications, represents a significant public health challenge—particularly among older adults, who are more likely to experience negative clinical outcomes attributable to adverse reactions to or interactions between their medications (Canadian Institute for Health Information, 2013). Improved medication management on the part of both patients and health care providers (HCPs) is needed to address the issues and consequences associated with polypharmacy, but conversations between patients and their HCPs about options for medication changes remain the exception. In a rural community near Ottawa, Ontario, a community-based participatory research (CBPR) approach aimed to support improved public awareness of and participation in medication management and deprescribing through educational events aimed at older adults. This paper describes the processes researchers used in collaboration with community members to discuss and address medication management in a locally relevant manner, details the results of these processes, and suggests how similar approaches may be employed to empower patients and communities to address issues of personal health care.

Sustainability for planetary health: A seventh domain of quality in primary care

“…Primary care practices should aim at reducing the environmental impact of prescribing and drug use. Currently, a major problem is polypharmacy and overprescribing ( 11 ), and other examples such as overuse of antibiotics and hypnotics. Tapering off medication can help improve the quality of life for patients ( 12 ) ,and better uptake of lifestyle interventions and social prescribing ( 13 ) can also be beneficial to patient outcomes.…”

Community engagement in a disengaged world: Developing and implementing educational workshops on deprescribing amid the COVID-19 pandemic

“…Following this advice, we went to members of the public and asked how we could support them in having these conversations with their providers. 19 They told us that they needed more information about their medications and ideas on how to talk with their health care providers; most felt they lacked the medication-related knowledge to have these conversations. 19 This feedback led us to expand our work into the area of public engagement and education.…”

“… 19 They told us that they needed more information about their medications and ideas on how to talk with their health care providers; most felt they lacked the medication-related knowledge to have these conversations. 19 This feedback led us to expand our work into the area of public engagement and education. We began to work with a public advisory group to develop a series of in-person educational workshops that could help people to build skills needed to have worthwhile discussions with their physicians about the possibility of deprescribing some of their medications.…”