Pharmacist Deprescribing Program Information

Green Shield Canada’s (GSC’s) Deprescribing Program is a cognitive service provided by pharmacists based on evidence-based guidelines for deprescribing developed by the Bruyère Research Institute and the Ontario Pharmacy Evidence Network (OPEN). To learn more, please click here.

Deprescribing is the planned and supervised process of dose reduction or stopping of medication that might be causing harm or might no longer be providing a benefit. The goal of deprescribing is to reduce medication burden and harm while maintaining or improving quality of life.¹

The program is available to eligible GSC plan members and their dependents.

In this program, where appropriate, pharmacists in a collaborative decision-making process with patients and physicians will assist in safely tapering or stopping patients who are on one of two classes of medications: proton pump inhibitors (PPIs) and/or benzodiazepines and Z-Drugs (BZRAs). This will be accomplished by:

• Identifying potential deprescribing opportunities by engaging patients who may benefit by discussing their condition being treated, the potential benefits and harms of continuing treatment,the benefits of deprescribing, potential risks, and a tapering plan, taking into account patient preferences and values.
• If a deprescribing opportunity is identified, with the permission of the patient, engage and communicate recommendations and next steps to the patient’s physician.
• During the duration of the tapering plan, regularly monitor, reassess, and follow up with the patient providing guidance, practical advice, and effective coaching to help patients manage any symptom relapse, adopting alternative non-drug or safer drug strategies to manage their condition and adjustments to treatment plan (if required).

Program Documentation and Forms

• GSC Deprescribing Program Guide
• Deprescribing Program Flowchart
• Medication Assessment Form
• Deprescribing Assessment Form
• Physician Communication Forms
  
  • PPI Pharmaceutical Opinion Template, reproduced with permission from Canadian Pharmacists Journal ²
  • Canadian Deprescribing Network’s Evidence-Based Pharmaceutical Opinion Forms (Sedative-hypnotic and Proton-pump inhibitor)

Evidence-based deprescribing guidelines have been developed by the Bruyère Research Institute. Each guideline is accompanied by a decision-support algorithm, patient friendly pamphlet, infographic, and a whiteboard video below:

Proton Pump Inhibitors (PPIs) ^3,4

• Proton Pump Inhibitor Evidence-based Deprescribing Guideline (published in Canadian Family Physician)
• Proton Pump Inhibitor Deprescribing Algorithm
• Deprescribing Pamphlet (PPI)
• Deprescribing Infographic (PPI)
• Whiteboard video on using the PPI Deprescribing Algorithm
• Proton Pump Inhibitor Patient Decision Aid

Benzodiazepine Receptor Agonists (BZRAs)^1,4

• Benzodiazepine Receptor Agonist Evidence-based Deprescribing Guideline (published in Canadian Family Physician)
• Benzodiazepine Receptor Agonist Deprescribing Algorithm
• Deprescribing Pamphlet (BZRA)
• Deprescribing Infographic (BZRA)
• Whiteboard video on using the BZRA Deprescribing Algorithm

For additional information and resources, please visit https://deprescribing.org/.

To download the complementary app developed by the Bruyère Deprescribing Guidelines Research Team for on-demand access to its deprescribing algorithms, click for iOS or Android . Once the app has downloaded, open it and add the Deprescribing Channel.

How to Participate

There is no required formal training program; however, it is GSC’s expectation that participating pharmacists are familiar, up-to-date, and competent with the Bruyère Research Institute and the OPEN’s evidence-based guidelines, algorithms, and resources to support safe deprescribing.

References:

• (1) Can Fam Physician 2018; 64: 339-51
• (2) Can Pharm J 2020; 153(1): 37–45
• (3) Can Fam Physician 2017; 63: 354-64
• (4) https://deprescribing.org/