Deprescribing Super Special III: Constance Fung, Emily McDonald, Amy Linsky, and Michelle Odden
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
3 speakers
4 chapters
transcribed 9 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
Why is deprescribing older adults’ medications so challenging?
Welcome to the Jerry PAL podcast. This is Eric Wadera. This is Alex Smith. And Alex, we got another deprescribing super special with us today.
We have a full house to talk about deprescribing. We're still working on this issue. We have not solved it apparently. Our first guest is Emily McDonald, who's a physician in general medicine, an epidemiologist, an associate professor in McGill. Emily, welcome to the JerryPal podcast.
Hi, thanks for having me.
Great. And our next guest is Amy Linsky, who's a physician and researcher at the VA Boston Healthcare System and associate professor at Boston University. Amy, welcome to JerryPal. Excited
to be here. Thanks.
And next we have Connie Fung, who I know well through the BCN community and is a physician researcher, professor of medicine at UCLA. And um we were talking about the fire situation there. I'm glad that's starting to resolve. Connie, welcome to JerryPowell.
Thank you. Great to be here.
And our last guest is Michelle Auden, who we know well used to be here, is now epidemiologist and research scientist at the Palo Alto VA and his associate professor in Stanford. Michelle, welcome to JerryPal.
Thank you for having me.
Okay, we got a lot to cover. Before we do, we always start off with a song request. Amy, do you have the song request for Alex? How
about just like a pill by Pink?
Why did you pick this sock?
I mean, in addition to the lyrics being pretty spot on, I kinda wanted to see Alex singing pink.
Yeah, this is a good challenge. Love it. Here we go.
I'm lying here on the floor. Will you left me? Think I took too much, I'm crying here What have you done? I thought it would be fun. Can't stay on your life support, there's a shortage in the switch Can't stay on your morphine, 'cause it's making me itch. I said I tried to call the nurse again, but she's being a little rich. Think I'll get out of here where I can run just fast as I can to the middle of nowhere. To the middle of my frustrated fuse and I swear you're just like a pill. Instead of making me better, you're making me ill. Just making me ill.
That was perfect for this deprescribing super stuff. Keep making
me out. I had to make one little edit there. I changed the word. Some of you may have noticed. That's
a new anthem for deprescribing.
Yes, right.
I didn't notice I'm not a pink super fan. Okay.
There was a nur a word about um I tried to call a nurse again, but she's being a little I changed it to Rich.
Okay, this is like our what fourth deprescribing super special. We haven't yet figured out why is it so hard. Well, I guess the question to all of you is why is deep prescribing so hard? It seems very easy to prescribe medicines, and we do that very well. Why is it so hard to Deeperscribing your thoughts. Who's up for taking that one?
At the risk of repeating what you've had said on your prior deprescribing ones, it's hard to undo things. And the analogy that I always give with deprescribing is the idea of cleaning out your closet. Like it sounds like a great, you know, rainy day activity. You take everything out, but then somehow your prom dress still ends up back in the closet because you might need it one day.
That's the hard thing, right? Like you've I've seen a lot of like benzo deprescribing interventions. And while it may work during the intervention, six months, a year later, a lot of people
are back on it. Yeah, there are so many forces acting against us, right? The system is not set up to deprescribe. It's not easy to communicate changes once you've made them. The patients don't always know what medications they're on. I mean, you know, there's tons of studies on why this is so hard and what the barriers are. We could have a whole episode just on, you know, why it's so difficult.
Yeah. It does seem though there there are barriers to taking your pills. You have to remember it. You gotta pick it up at the pharmacy. Sometimes you have to pay for it. Sometimes you have to pay a lot for it. There's all of these also barriers that seem to be like it's very hard for me to remember to take any medicine.
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Chapters
4 chapters
1
Why is deprescribing older adults’ medications so challenging?
0:00–12:36
2
How did the masked taper‑plus‑augmented CBT‑I study reduce benzodiazepine use?
12:36–25:00
3
What impact did direct‑to‑consumer brochures have on gabapentin deprescribing?
25:00–38:40
4
Can patient‑directed brochures increase clinician deprescribing of low‑benefit meds?
38:40–49:47
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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