Second annual stakeholder meeting on safe medication management for older men and women across Canada
In January 2015, Dr. Cara Tannenbaum, the Scientific Director of the CIHR Institute of Gender and Health, hosted the First National Stakeholder Council Meeting on Safe Medication Management for Older Men and Women across Canada. Currently, approximately 25% of Canadian seniors are consuming at least one medication deemed to be unnecessary and even harmful for elderly patients. These prescriptions pose health risks for older adults—especially for women, who consume more medication than men—but reducing a patient's exposure to multiple or inappropriate medications, known as de-prescribing, is a complex process. The meeting in 2015 brought select stakeholders together to develop an action plan to "de-prescribe" Canadian seniors.
- To bring key stakeholders together who are committed to advancing the de-prescribing of inappropriate medications in Canada;
- To share current best practices of de-prescribing inappropriate medications in order to encourage solution-focused discussion and networking; and
- To introduce the concept of the Canadian De-prescribing Network and build support and interest in its potential development, mission and strategy.
On January 28th, 2016, the second stakeholder meeting was held in Toronto with nearly 100 delegates from all across the country. Doctors, pharmacists, researchers, health system specialists, as well as representatives from Canadian associations, non-profit organizations, and the private sector came together to learn about the action plan that was created at the 2015 meeting and progress to date. The resulting discussions led to new connections and a lot of excitement, while a unique "de-prescribing fair" also encouraged participants to learn about the tools, resources and initiatives that have already been developed to support the growing de-prescribing movement across Canada.
Dr. Tannenbaum and her co-chair, Dr. James Silvius, were delighted to welcome Chris Power, the Chief Executive Officer of the Canadian Patient Safety Institute, as the keynote speaker. Drawing from her own personal and professional experiences, Chris Power inspired the crowd to consider "the art of the possible" in safe medication management.
A complex process
"First, do no harm."
It's a fundamental principle in healthcare around the world to ensure that the benefits of care outweigh the risks of harm. This principle holds true for de-prescribing, too: stopping or reducing a medication should be done safely, strategically, and under the supervision of a medical professional.
That said, many players need to be involved to curb the prescription of inappropriate medications across Canada. A multi-level ecologic strategy is required – one that simultaneously targets patients directly, their healthcare providers, organizations and decision-makers. Sustainable change is possible, but only with multifaceted interventions that bring about culture change in all these different sectors. For instance, if patients are expected to reduce their consumption of medication to treat physical symptoms, then access to non-pharmacological therapy should be improved.
The Action Plan to Improve Safe and Appropriate Medical Therapy for Older Men and Women across Canada, developed at the meeting in 2015, envisages two overarching goals:
- Achieving a 50% reduction of inappropriate prescriptions for seniors over the next three years; and
- Ensuring access to safer pharmacological or non-pharmacological therapies.
Five sub-committees were formed in 2015 to address various aspects of these goals, and new advocates and partners continue to be recruited as additional collaborators. The next step is to link the interested participants from the 2016 meeting to the work of these sub-committees, forming a Canadian De-Prescribing Network with national scope and potential for impact.Building on the progress made in 2015, the Network will also continue its work to raise public awareness of the potential harms of certain medications such as sleeping pills, chronic use of proton pump inhibitors, antipsychotics used in persons with dementia, and even certain diabetes medication.
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