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A-Fib Patients (and Others): Should You Be Prescribed Fewer Drugs?

Did you know you can outgrow your medication? Perhaps your lifestyle has changed with more physical activity, better nutrition or weight loss and subsequently you may no longer need medications for diabetes, cholesterol or high blood pressure.

But you keep taking them, because no one told you to stop.

Simple errors can occur, too. Dr. Michael A. Steinman, a geriatrician at the University of California, San Francisco, recalled asking a patient to bring in every pill he took for a so-called ‘brown bag review’. He learned that the man had accumulated four or five bottles of the same drug without realizing it, and was ingesting several times the recommended dose.

“We spend an awful lot of money and effort trying to figure out when to start medications and shockingly little on when to stop.”

Dr. Caleb Alexander, Johns Hopkins Center for Drug Safety and Effectiveness

De-Prescribing: A Brown Bag Review

Always keep an accurate and updated list of medications you are taking. (See our free download form below.)

Periodically ask your physicians or pharmacist for a ‘brown bag review’. Discuss whether to continue or change any of your regimens. Ask about:

▪ any medicines you no longer need?
▪ any medications you can do without?
▪ if a lower dose would work for any of your medicines?
▪ if any of your medications might interact with another?
▪ any non-pharmacologic alternatives?

If your doctor agrees to ‘de-subscribe’ a medication, realize it isn’t as simple as saying “stop” taking it. It’s a process requiring caution and skill by your doctor. (Afterwards, remember to update your list of medications.)

Free Download: Keep an Inventory List of Your Medications

Medications List from Alere at A-Fib.comKeep your doctor and other healthcare providers up-to-date on all the medications you are taking by using this Medications List from Alere. Download (and remember to save the PDF to your hard drive).

Besides prescriptions, the form has sections to list over-the-counter drugs, vitamins, herbs and mineral supplements, too (as they can interact).

Print several copies of the blank form and keep handy in your A-Fib file or binder. When completed, give a copy of your inventory to each of your healthcare providers.

Also see my article: Are Your Herbal Supplements Interacting With Your Medicines?

Resources for this article
• Kantor ED, et al. Trends in Prescription Drug Use Among Adults in the United States From 1999-2012. JAMA. 2015;314(17):1818–1830. doi:10.1001/jama.2015.13766

• Mishori, R. Why doctors should be prescribing less drugs. The Independent. 30 January 2017. http://www.independent.co.uk/life-style/health-and-families/healthy-living/prescribing-drugs-is-good-so-is-deprescribing-a7552971.html

• Qato DM, et al. Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. JAMA Intern Med. 2016 Apr;176(4):473-82. doi:10.1001/jamainternmed.2015.8581.

 

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