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Headline

Pharmacists must work with others to roll back polypharmacy culture

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Published on: 24 February 2017 in European Journal of Hospital Pharmacy. Response to : ‘Can I stop even one of these pills?’ The development of a tool to make deprescribing easier.Alan Cassels Deprescribing in the population with intellectual disabilities Bernadette Flood. PhD MPSI. The population with intellectual disabilities are vulnerable in the prescribing and the deprescribing process. In the population with intellectual disabilities compared to the general population, the multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs [1]. People with intellectual disabilities use multiple medications and may have been taking them for many years. Extreme care in required when de- prescribing many medications in this population group. The principles of good de-prescribing during medication review in the population with intellectual disabilities, based on the British Pharmacological Society’s Principles for Good Prescribing 2010, provide a template for quality de-prescribing in this vulnerable population group. Principles of Good De-prescribing during Medication Review in the Population with Intellectual Disabilities and Behaviour Disorders. Based on the British Pharmacological Society’s Principles for Good Prescribing 2010 1. Be clear about the reasons for de-prescribing. 2. Take into account the patient with intellectual disabilities and behaviour disorders medication history before de-prescribing. 3. Take into account other factors that might alter the benefits and risks of de-prescribing treatment in the patient with intellectual disability and behaviour disorders. 4. Take into account the patient’s/carer’s/families/advocates ideas, concerns, and expectations. 5. Ensure all medicines are effective, safe, cost-effective in appropriate form individualised for the patient with intellectual disability, behaviour disorders and other conditions such as dysphagia, autism. 6. Adhere to national guidelines and local formularies where appropriate. Use caution where the population with intellectual disability have not been considered in the guideline development process. 7. Write unambiguous correct documentation detailing reason for de-prescribing. 8. Monitor the beneficial and adverse effects of de-prescribing medicines and any effects on behaviour. 9. Communicate and document all de-prescribing decisions and the reasons for them such as transferred to appropriate personnel such as GP, pharmacist, psychiatrist, epileptologist, carer and patient. 10. De - prescribe within the limitations of your knowledge, skills and experience of the population with intellectual disabilities and behaviour disorders. 1. Cooper S-A, McLean G, Guthrie B, et al. Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis. BMC Family Practice. 2015;16:110. doi:10.1186/s12875-015-0329-3.

Posted date

22 JUL 2019

Posted time

15:22

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