Why good healthcare can mean stopping medicines, not starting them

Sly Saint

Senior Member (Voting Rights)
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an NHS scheme has launched to help doctors identify when people are taking too many medicines, and to work out which ones are doing more harm than good.

Such “deprescribing” initiatives can seem counterintuitive, said Clare Howard, a pharmacist in Wessex, who is clinical lead for the NHS’s Health Innovation Network’s polypharmacy programme. (Polypharmacy just means when people take multiple medicines.)

But all drugs have risks as well as benefits, and as people get older, sometimes that risk-benefit equation changes, she said. “There’s a growing body of evidence that is starting to show us where we are causing more harm.”

This week, more research was published backing deprescribing, showing that it can also be helpful for people with dementia, where there are particular pitfalls of taking too many medicines.

But regardless of the person’s age or health status, doctors are being encouraged to proactively check if people could reduce or stop any of their tablets through a process called a structured medicines review.

Taking multiple medicines can also be dangerous, as they may interact with each other and cause side effects, such as nausea or drowsiness, which could cause falls.

Medication side effects are responsible for one in six emergency hospital admissions, with polypharmacy being a large driver of this problem, according to a recent study of a Liverpool hospital.
many types of medicines can make people less mentally sharp because they block activity of an important brain signalling molecule called acetylcholine. Examples include antihistamines for allergies, certain antidepressants and some pain relievers.

In fact some of the few medicines that can reduce the memory problems of Alzheimer’s disease work by boosting acetylcholine. So it is alarming that some older people are unwittingly taking drugs that have the opposite effect, said Dr Kinda Ibrahim, a primary care researcher at the University of Southampton.
Why good healthcare can mean stopping medicines, not starting them
 
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