To Take or Not to Take? 

By October 30, 2018 No Comments
Palliative Care

To Take or Not to Take. That is the question.  Should I take this pill or not?  In the last few weeks I stopped taking a baby aspirin.  I started some years ago when I took a look at my family history.  We Baileys seem to burn the candle at both ends and sadly, longevity does not run in my family!  I thought, a baby aspirin is good for what ails you and what is the harm?  I trotted off to the local pharmacy and stocked up.  Over the last 10 years the benefit of baby aspirin as a preventative measure has been chipped away.  First not so helpful in women and then perhaps not in men.  Recently NEJM put out the definitive article that demonstrated lack of benefit and about a 3% chance of some serious bleeding.*

Out! Out you damn Aspirin!

Healthcare providers often see people who need a cart to push around all the drugs they are prescribed.  Do they want them? Do they need them?  An interesting study looking at the deprescribing attitudes of Medicare patients was published in JAMA Internal Medicine this week.  Apparently a lot of the study participants thought they might be on too many medicines.  A reported 9 in 10 said they would be interested in talking with their healthcare provider about stopping at least 1 of their medications. In addition, two-thirds reported that they wanted to take less medication in general.

Oh drat, another thing to talk about in an already tight provider schedule!  However, this is a win-win! People will take fewer pills, will experience less side effects, and will avoid cost while providers will have to handle less deprescribing issues in the future.

* McNeil, J. J., Woods, R. L., Nelson, M. R., Reid, C. M., Kirpach, B., Wolfe, R., … & Newman, A. B. (2018). Effect of aspirin on disability-free survival in the healthy elderly. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa1800722
Reeve, E., Wolff, J., Skehan, M., Bayliss, E., Hilmer, S., Boyd, C. (2018) Assessment of Attitudes Toward Deprescribing in Older Medicare Beneficiaries in the United States. JAMA Internal Medicine. Retrieved October 16, 2018 from https://jamhttps://www.nejm.org/doi/full/10.1056/NEJMoa1800722anetwork.com/journals/jamainternalmedicine/fullarticle/2706177?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=101518

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