Polypharmacy Prompts by Abigail Hardin https://padlet.com/hardinabigail10/qu8q3xdtj581z5di POLYPHARMACY is when an individual taking 5 or more medications at one time. DEPRESCRIBING is the process of tapering, discontinuing, or withdrawing medications that may be causing harm or no longer be beneficial. en-us 2020-11-19 17:47:11 UTC 2021-03-23 18:31:57 UTC hello@padlet.com Figuring out initial indication for which the med was started.... not being able to easily communicate with the prescribing provider https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945625623 2020-11-20 15:20:34 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945625623 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627208 Have a standardized way to address patients' medication lists, including frequency and provider responsible for doing so. ]]> 2020-11-20 15:20:55 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627208 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627614 Build it into conversations with parents and patients. 
Consider systems to encourage those conversations, consider associating diagnoses at med rec. ]]> 2020-11-20 15:21:00 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627614 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627654 multiple prescribers making it difficult to determine what each med is used for]]> 2020-11-20 15:21:00 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627654 Most children i know have more than one medical condition that requires different meds for treatment https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627907 2020-11-20 15:21:03 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945627907 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945630493 keeping track of times of day, keeping track of most recent dose

]]> 2020-11-20 15:21:35 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945630493 keeping track of routine follow up needed for every medication such as labs or imaging. https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945631560 2020-11-20 15:21:50 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945631560 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945632382 we don't want to cause harm or discomfort]]> 2020-11-20 15:22:00 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945632382 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634077 keeping track of why med was started]]> 2020-11-20 15:22:22 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634077 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634456 common meds or 2 med combos that might be "low-hanging fruit" for de-prescribing

]]> 2020-11-20 15:22:27 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634456 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634726 there are medications that are used to treat common complaints, and they're started "to see if it helps" and then there's an observed benefit, at least at first. 
Also, many of the medications that are on med lists are thought of as low risk on their own (PPI, H2 receptor antagonists, laxatives, anti-sialorrhea meds, antihistamines, etc)]]> 2020-11-20 15:22:31 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945634726 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635010 Many of them have many providers, including their primary care provider and subspecialists, which can lead to a lot of different people prescribing and managing medications ]]> 2020-11-20 15:22:34 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635010 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635566 uncertainty of result of deprescribing]]> 2020-11-20 15:22:41 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635566 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635659 Help parents understand the negative side effects more. Benefits vs long term harm

]]> 2020-11-20 15:22:42 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945635659 understanding initial indication https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945637365 2020-11-20 15:23:05 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945637365 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945638026 they have multiple medical conditions

]]> 2020-11-20 15:23:15 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945638026 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945638171 medications without a clear indication or overlapping indication with another med]]> 2020-11-20 15:23:17 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945638171 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945639403 many providers are involved in the child's care]]> 2020-11-20 15:23:29 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945639403 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945640198 causing discomfort or harm]]> 2020-11-20 15:23:39 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945640198 wean plans created with pharmacist https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945640515 2020-11-20 15:23:43 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945640515 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945641434 to discuss the potential benefits longterm]]> 2020-11-20 15:23:55 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945641434 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945643415 multiple care providers. attempts at symptom management. hospital stays!]]> 2020-11-20 15:24:17 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945643415 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945644969 empower me to stop medications or build systems or cultures around discussing medications among a patient's many providers to allow me to stop a med with easier buy in from other providers. ]]> 2020-11-20 15:24:38 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945644969 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945645248 have a way to contact prescribing/managing providers]]> 2020-11-20 15:24:40 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945645248 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945645363 family preferences]]> 2020-11-20 15:24:42 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945645363 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945647515 There is a high burden on the family for managing the timing, doses, and management of multiple different medications ]]> 2020-11-20 15:25:09 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945647515 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945647742 have to restart a medication thus losing the trust of the family]]> 2020-11-20 15:25:12 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945647742 they trust previous providers who started the treatment, anxiety/ not wanting to rock the boat https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945649811 2020-11-20 15:25:38 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945649811 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945651074 patient's condition worsening
parental frustration with being constantly asked to stop medications]]> 2020-11-20 15:25:53 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945651074 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945651190 trying to figure out who is the managing provider]]> 2020-11-20 15:25:54 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945651190 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945653310 discuss how if successful care would be simplified]]> 2020-11-20 15:26:21 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945653310 Many parents lack understanding of importance of meds long term. https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945653767 2020-11-20 15:26:27 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945653767 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945654205 objective assessment of effectiveness is difficult or may require unnecessary diagnostics, including invasive procedures]]> 2020-11-20 15:26:33 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945654205 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945659019 a family is doing their best, and relying on this advice to keep their child at their best]]> 2020-11-20 15:27:36 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945659019 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945659629 it is easier to "try something". Often times there is not a clear expectation of what success of a medication trial would look like so it just stays on. Occasionally it a short term med may get left on after a hospitalization]]> 2020-11-20 15:27:43 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945659629 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945660723 Conversations with the patient's family and subspecialty provider if appropriate]]> 2020-11-20 15:27:54 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945660723 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945661721 evidence based nuance to drug interactions, better interaction alerts
parent education about the benefit of deprescribing]]> 2020-11-20 15:28:07 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945661721 understanding risk vs benefit https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945665947 2020-11-20 15:28:59 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945665947 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945667384 clear discussions at the start of a new med about what success looks like and expecations that we would stop the med if it does not meet that goal (or stops meeting the goal in the future)]]> 2020-11-20 15:29:17 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945667384 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945672965 suggests lots of providers as well]]> 2020-11-20 15:30:29 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945672965 https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945674401 parents thinking they really depend on the medication]]> 2020-11-20 15:30:48 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945674401 fear of unknowns https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945675954 2020-11-20 15:31:08 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945675954 for some families keeping up with times. our transplant team made this incredibly easy with a heart chart. fantastic solution to this issue https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945683689 2020-11-20 15:32:49 UTC https://padlet.com/hardinabigail10/qu8q3xdtj581z5di/wish/945683689