The first phase of a new multi-part research initiative at Richmond Hospital aims to tackle the issue of over-medication in seniors by looking to reduce the amount of drugs they take.
The study will mark the first instance in B.C. of a community, acute-care facility performing the kind of clinical research usually done at larger hospitals.
"The fundamental basics for doing it is that the number of prescriptions older patients are taking is growing," said Dr. Scott Garrison, the new medical research director for Vancouver Coastal Health in Richmond.
"It's a recognition that there's a problem with how we treat the elderly. Our primary motive is to improve their quality of life and independence."
Garrison is applying for grants to begin the project, which will involve enrolling Richmond patients in a study where they are randomly assigned to a method of minimizing their medication intake.
Participating physicians in the city will be asked to select patients for the study based on a prescription drug profile and whether they would be willing to reduce their dosage. Garrison said he will spend the next year determining which physicians will take part.
The process, called polypharmacy reduction, or simply "deprescribing," seeks to improve the patient's quality of life by simplifying medication regimens and cutting down the risk of drug side-effects that may result from taking bloated pill cocktails.
"As you increase medication, you exponentially increase the potential for sideeffects," he said. "It happens to people of all ages, but the elderly are more susceptible."
The pilot phase in Richmond, which will last up to a year, will determine the optimal deprescribing plan and see if the trial design is workable for both patients and doctors.
The study hopes to reduce dosages of drugs like antidepressants, antipsychotics, pain medication and sedatives. If the trial is successful, Garrison hopes to expand the program and involve more than 200 physicians and 1,500 patients across the province. He is confident the response to the trial will be favourable.
The over-medication of seniors in B.C. is a "huge issue," according to Dr. Gloria Gutman, professor emeritus at Simon Fraser University and research associate at the school's Gerontology Research Centre. Gutman sees two positive outcomes in Garrison's study.
"It's better for the patient and it's also good as a cost-cutting measure," she said. "Much of the yelling and screaming on increases in medical costs are the result of new technology and prescription medication. Drugs are a big driver."
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