Deprescribing Pharmacy: DNA, Wellness & the Future of Healthcare with Dr. DeLon Canterbury

WEBVTT
00:01:00.684 --> 00:01:08.640
Now, medications certainly have their place, but what if there was a way to support your body naturally by working with your genetics?
00:01:08.939 --> 00:01:11.706
We are a pill for an ill society.
00:01:11.706 --> 00:01:15.674
We take 18 pills per person per American per day.
00:01:15.879 --> 00:01:22.906
It was so hard to find somebody who took my insurance and for me to get well it took thousands of dollars and I thought what do regular people do?
00:01:22.906 --> 00:01:24.030
This is not right.
00:01:24.030 --> 00:01:30.445
Despite my best efforts, I wasn't actually reversing disease and helping people to heal in the way that I thought I would.
00:01:30.445 --> 00:01:33.990
We want to empower yourselves to take care of this root cause.
00:01:33.990 --> 00:01:35.486
We don't just want to cover it up.
00:01:37.859 --> 00:01:42.587
If you want to break the mold of traditional pharmacy and healthcare, you are in the right place.
00:01:42.587 --> 00:01:46.653
Welcome to the Pivoting Pharmacy with Nutrigenomics podcast.
00:01:46.653 --> 00:01:48.474
Here's a little truth bomb.
00:01:48.474 --> 00:01:56.960
We're all unique, down to our DNA, so it's no wonder we react differently to the same medications, foods and environment.
00:01:56.960 --> 00:02:09.207
Here's a million dollar question how can you discover exactly what your body needs, which medication, what foods or supplements and which exercises are right for you?
00:02:09.207 --> 00:02:14.507
How can you manage chronic conditions like diabetes without more medications?
00:02:14.507 --> 00:02:18.256
How can you lose weight and keep it off?
00:02:18.256 --> 00:02:25.393
How do you tap into your genetic blueprint so you can stop surviving and start thriving in health and life?
00:02:25.393 --> 00:02:29.330
That is the question, and this podcast will give you the answer.
00:02:29.330 --> 00:02:32.870
I'm your host, Dr Tamar Lawful, doctor of pharmacy.
00:02:32.870 --> 00:02:37.451
Let's pivot into genomics and bring healthcare to higher levels.
00:02:38.659 --> 00:02:40.728
Welcome to Pivoting Pharmacy with Nutrigenomics.
00:02:40.728 --> 00:02:41.902
I'm your host, Dr.
00:02:41.902 --> 00:02:46.593
Tamar Lawful, and today we're celebrating our 100th episode.
00:02:46.593 --> 00:02:47.756
Can you believe it?
00:02:47.756 --> 00:02:54.094
Whether you've been listening since day one or this is your first episode, I just want to say thank you.
00:02:54.094 --> 00:03:04.301
To mark this milestone, I invited someone really special, a colleague, a friend and someone who's on a similar mission to mine but takes a different route.
00:03:04.301 --> 00:03:08.632
You may know him as the deprescribing pharmacist, r.
00:03:08.632 --> 00:03:09.836
DeLon Canterbury.
00:03:09.836 --> 00:03:14.891
He's making waves in the world of medication safety, especially among our aging population.
00:03:14.891 --> 00:03:29.697
Now we may use different tools he focuses on traditional deprescribing and I use nutrigenomics to get to the root causes but our goal is the same helping people live healthier lives with fewer unnecessary medications.
00:03:29.697 --> 00:03:36.073
So today we're pulling back the curtain on what deprescribing really looks like from both sides of the spectrum.
00:03:36.073 --> 00:03:37.600
Welcome, Dr.
00:03:37.600 --> 00:03:38.341
Canterbury.
00:03:38.341 --> 00:03:39.623
Thank you for joining us today.
00:03:40.243 --> 00:03:46.972
Hey, Tamar, it's such a pleasure to be here with you celebrating your 100th episode.
00:03:46.972 --> 00:03:47.772
Welcome all.
00:03:47.772 --> 00:03:48.854
Thanks for having me.
00:03:49.596 --> 00:03:50.216
You are welcome.
00:03:50.216 --> 00:03:55.453
Thanks for accepting my invitation to be my 100th guest and share this special moment with me.
00:03:55.453 --> 00:03:58.147
Now I want to take it back for a second.
00:03:58.147 --> 00:04:02.605
You know we both started in traditional pharmacy, but clearly something shifted right.
00:04:02.605 --> 00:04:07.834
I want to know what made you start focusing on deprescribing as your mission in pharmacy.
00:04:08.313 --> 00:04:13.846
Yeah, yeah, you know I could tell everyone.
00:04:13.846 --> 00:04:15.199
You know, we didn't really learn about deprescribing in school, right?
00:04:15.199 --> 00:04:20.393
We kind of got into the field, got your hands wet and you started seeing the problem firsthand.
00:04:20.393 --> 00:04:38.500
So for me, I came from the traditional community retail pharmacy route, finishing up from UNC School of Pharmacy in 2014, and being thrust into a very rural and aging community in Henderson, north Carolina, while I was serving as a pharmacy manager.
00:04:38.840 --> 00:04:49.596
And so, working as a pharmacy manager, of course, you see day in, day out the operations, the business side, but you get to be, you know, a key community stakeholder and a trusted confidant.
00:04:49.596 --> 00:05:01.672
And what I started noticing were my older patients were constantly in and out of the ER or the urgent care and in a community like this, there aren't that many providers and resources for care.
00:05:01.672 --> 00:05:05.586
This there aren't that many providers and resources for care.
00:05:05.586 --> 00:05:08.136
In fact, a number of them were torn between transportation to pick up their medications.
00:05:08.136 --> 00:05:18.826
There were these social barriers, like even getting a ride, a family member affording gas money, choosing between a medication or a light bill and I found a lot of them were my older adults.
00:05:18.826 --> 00:05:23.909
So it really helped me kind of have my red flags go up.
00:05:23.909 --> 00:05:26.201
You know, why is this population going through so much?
00:05:26.201 --> 00:05:27.084
Like what's the issue?
00:05:28.185 --> 00:05:46.173
And I started getting into studying for the certification in geriatric pharmacotherapy, so got my BCGP credential in 2017 while working as a pharmacy manager and, boom, my eyes opened to deprescribing medication safety.
00:05:46.173 --> 00:05:48.408
What are some of the common tools out there?
00:05:48.408 --> 00:05:55.093
Why does the aging body, or how does it, differ from people in our middle of 40s and 30s in age?
00:05:55.093 --> 00:06:00.266
And the pathophys, the pharmacology is just completely different and aging is completely different.
00:06:00.266 --> 00:06:14.536
So once I got that, it opened my eyes to inherently have known this concept, but it became really a buzzword in more recent years and eventually led to me starting Geriatrics, my company, in 2020.
00:06:24.360 --> 00:06:26.425
in a hospital setting, I noticed that people were frequently coming in.
00:06:26.425 --> 00:06:32.326
The hospital is a revolving door for certain patients and, yes, between certain ages, especially the elderly, they tend to be in a lot more medications.
00:06:32.326 --> 00:06:42.171
They're having more side effects and drug interactions, so of course they're going to end up back in the hospital because of the multi-use of those medications.
00:06:42.171 --> 00:06:53.026
So is there a specific moment that you remember that managing meds just wasn't enough anymore, when you said to yourself you know what this is not cutting it?
00:06:53.026 --> 00:06:55.108
Was there a specific moment that you recall?
00:06:55.699 --> 00:07:12.360
Yes, I remember the moment where it really stuck with me that there has to be a different way and it was when I was in Henderson, north Carolina, as a pharmacy manager and one of my favorite patients was a vet and he came in hobbling.
00:07:12.360 --> 00:07:28.697
He also had a wheelchair assistive device and he was taking between 360 Pcocet, 10, 325s or 540 it depend on the year, I guess, type of time of year.
00:07:28.697 --> 00:07:33.860
And you know, after a while I'm refilling this, I'm like this is insane numbers like is this normal?
00:07:33.860 --> 00:07:37.666
Every time he gets it right on time, never early, never late.
00:07:37.666 --> 00:07:43.605
And you know, one day I um just had to ask like man, is this, is this even?
00:07:43.685 --> 00:07:46.091
helping with your pain, Like what is this doing?
00:07:46.240 --> 00:07:47.843
And he's just like you know what Delon this.
00:07:47.843 --> 00:07:50.932
Honestly, this just takes off the edge.
00:07:50.932 --> 00:08:01.204
I'm still in chronic pain every day of my life, I mean all over, and he had like a major back injury and it was just horrible lifestyle for this guy.
00:08:01.204 --> 00:08:17.197
I mean, here's a vet who's now subjected to 360 percocets, having a whole bowel regimen, having all these quality of life issues, and I learned that he just hasn't explored any other type of way to heal.
00:08:17.197 --> 00:08:24.721
You know, nothing like chiropractor or energy healing or even type of spiritual healing or just trying a different approach.
00:08:24.721 --> 00:08:36.220
Right, and I think even with pain, we know sometimes the overuse of opioids can lead to sensitivities and eventually, chronically, we just find that they're not always the best option.
00:08:36.220 --> 00:08:43.474
So to me that was an element that was going home and wondering is this what I'm supposed to do for the?
00:08:43.494 --> 00:08:44.120
rest of my life.
00:08:44.221 --> 00:08:48.432
Am I supposed to just sign off and subject people to this?
00:08:48.432 --> 00:08:55.792
Only way to heal right, at least from the manager standpoint or the business of pharmacy, is keep those scripts coming.
00:08:55.792 --> 00:09:11.793
And it really, morally, was in this alignment with what I felt I could do or what I studied for and what I know our Caribbean roots have us introspect is the natural way to heal and other modalities.
00:09:11.793 --> 00:09:14.147
So that was a nail in the head for me.
00:09:14.588 --> 00:09:30.081
And seeing how a lot of my members in the community who were older were the ones choosing between, you know, a light bill and transportation, choosing between a prescription and food, you know that was the common complaint that I would see with older adults.
00:09:30.081 --> 00:09:33.770
And that was where I realized, you know, that these guys need an advocate.
00:09:33.770 --> 00:09:43.471
They need someone who's well experienced in the world of medicine safety and, more importantly, someone who can also advocate for less.
00:09:43.471 --> 00:09:47.043
And I mean imagine a pharmacy where people are deprescribing.
00:09:47.043 --> 00:09:49.811
I mean god, wouldn't that just change the way we do business?
00:09:49.811 --> 00:09:53.288
And that's what struck a chord with me and got me down this road.
00:09:53.349 --> 00:10:02.403
It's starting geriatrics well, not deprescribing, taking people off medications, dr Canterbury, uh, so much we could unpack there.
00:10:02.403 --> 00:10:06.340
I love that you were pretty much boots on the ground.
00:10:06.340 --> 00:10:19.573
You were there in a mixed scene the elderly patients, the amount of medications they're on, and many times it's just putting a Band-Aid on the problem that patient was in pain.
00:10:19.573 --> 00:10:34.546
The Band-Aid treating the symptom versus the cause, or even finding other ways that they can deal with their pain, is not the first go-to in traditional health care practice, and especially in america.
00:10:34.546 --> 00:10:36.711
But the fact of the matter is it's going to happen.
00:10:36.711 --> 00:10:38.361
Medication is going to be prescribed.
00:10:38.361 --> 00:10:39.985
That's just how it works.
00:10:39.985 --> 00:10:50.773
So why not be that advocate for them as you are, as you discovered you needed to be, to at least help them do it safely, to help them do it safely.
00:10:50.773 --> 00:10:54.033
And I know we've been saying de-prescribing, de-prescribing so much.
00:10:54.033 --> 00:10:58.967
But for those who are listening, maybe this is the first time they've even heard that terminology.
00:10:58.967 --> 00:11:01.282
How can you explain that?
00:11:01.282 --> 00:11:04.182
How do you define de-rescribing in a way that people can actually relate to?
00:11:05.304 --> 00:11:14.607
We like to describe it as essentially the safe and supervised removal of medications that are no longer helping you.
00:11:14.607 --> 00:11:26.268
Really, it's done, of course, with a provider, making sure, of course, there's no issues with withdrawal or any relapse of some of the symptoms or conditions you were once treating.
00:11:26.268 --> 00:11:41.409
But, in a nutshell, deprescribing is safely removing medicines that no longer are needed and as we age, you know, I like to tell people there's a general timeline for certain medications, and I think that's an underappreciated concept.
00:11:41.409 --> 00:11:59.972
But every medicine to me has a timeline, and so we are simply assessing the pros of you keeping this medication on board or the cons of potentially stopping this medication, and so, with de-prescribing, hand in hand comes good prescribing practices.
00:11:59.972 --> 00:12:07.610
So, again, it's simply removing medications that you really may not need anymore or, in fact, could be considered harmful.
00:12:07.899 --> 00:12:09.307
Thank you for explaining that.
00:12:09.307 --> 00:12:15.969
Breaking it down Now, how do you personally measure the success with a patient when it comes to deprescribing?
00:12:15.969 --> 00:12:17.211
What's the deprescribing win?
00:12:17.879 --> 00:12:23.692
The biggest win for me and for my clients and the providers is quality of life.
00:12:23.692 --> 00:12:32.732
That is key for patients coming to us, and we were taking on clients all over the country who are coming with a problem.
00:12:32.732 --> 00:12:37.408
Is it constipation, is it incontinence, is it worsening memory?
00:12:37.408 --> 00:12:39.412
Is it a fall?
00:12:39.412 --> 00:12:47.588
Whatever the case is, there's some trigger point that's leading patients to seek out our services and get a consult.
00:12:48.320 --> 00:12:55.573
And so we start with the aging-friendly mnemonic, the four Ms what matters most to the patient?
00:12:55.573 --> 00:13:00.049
How are we preserving their mobility, how are we preserving their mindset?
00:13:00.049 --> 00:13:05.831
And, lastly, how are we looking at the medications and seeing if they conflict with any of the above?
00:13:05.831 --> 00:13:11.211
And so, really, when you leave with patient-centered care, we're leaving with what matters most.
00:13:11.211 --> 00:13:25.938
So if you're coming with me and you have an issue about wanting to see your grandbabies, you want to walk more, you want to hang out with your wife, we can align that to our treatment plan or deprescribing plan and see if the meds conflict with any of those above.
00:13:25.938 --> 00:13:44.413
And so when we're resolving a symptom, an issue, a side effect, or consolidating a med or two that were the causative issue, my friend, we're all winning and that makes me feel happy, and my patients, of course, are living much better, along with, of course, the caregiver, who's the one managing all this at the front lines.
00:13:45.139 --> 00:13:48.629
I love that, because it's not how many medications they were able to get off of.
00:13:48.629 --> 00:13:51.081
You're not measuring it by that.
00:13:51.081 --> 00:13:52.682
It's not how many medications they were able to get off of.
00:13:52.682 --> 00:13:54.003
You're not measuring it by that.
00:13:54.003 --> 00:14:02.269
Quality of life is so important because it plays into every aspect of their health the emotional health, the physical health, mental health.
00:14:02.269 --> 00:14:04.591
How is their quality of life?
00:14:04.591 --> 00:14:21.662
And, amazingly, when that quality of life is great, it starts improving all those other aspects the emotional, the physical and the mental as well.
00:14:21.662 --> 00:14:22.663
So that's like holistic care in a nutshell.
00:14:22.663 --> 00:14:23.306
You have to place it that way.
00:14:23.306 --> 00:14:24.609
But thank you for sharing that with us.
00:14:24.609 --> 00:14:29.885
Now I want to talk about what this actually feels like for the people that you help.
00:14:29.885 --> 00:14:37.009
You know what are the most common complaints or symptoms that they come to you with, especially when they're on so many medications.
00:14:38.561 --> 00:14:41.309
You know precisely what you just said.
00:14:41.309 --> 00:14:54.862
I feel like I'm on too many medications and no one really takes the time of day to do a deep dive into why they're on all of them, in fact majority admit to.
00:14:54.862 --> 00:14:59.543
Well, I just do what my doctor says and no one's told me otherwise for the last 20, 30 years.
00:14:59.543 --> 00:15:06.484
Frankly, with older adults, or seasoned ones, I like to call them, it could be a multitude of issues I'd say.
00:15:06.484 --> 00:15:11.133
Commonly there are osteoarthritis pains.
00:15:11.133 --> 00:15:27.721
There are general dizziness or fatigue during the day, sometimes nauseousness when taking certain medications, sometimes more severe, sometimes it's concerns about memory loss, sometimes it's signs of incontinence at night or insomnia.
00:15:27.822 --> 00:15:40.044
I definitely get a good number of people with difficulty sleeping and you start unearthing that there may be some unresolved anxieties or untreated depressions that haven't been addressed in your lifetime.
00:15:40.044 --> 00:15:42.229
So it can really range.
00:15:42.229 --> 00:15:45.826
I would say to ask the patient let's talk about their bowels.
00:15:45.826 --> 00:15:46.769
That's a huge thing.
00:15:46.769 --> 00:15:51.928
So getting regular is always a topic of discussion, but it can absolutely vary.
00:15:51.928 --> 00:16:08.240
But I would say pain is one of your more common ones chronic pain or issues around bowel movements, incontinence, insomnia and yeah, I'm seeing like some general just tiredness and malaise throughout their days.
00:16:08.862 --> 00:16:19.442
Yeah, I could imagine that's what would happen, right, yeah, now I want to highlight our different approaches to what we do with each of our patients.
00:16:19.442 --> 00:16:33.301
I call them clients because I'm more in the coaching setting, where I'm just empowering them to really own their habits so that they can be empowered to make the changes in their life to eventually come off medications.
00:16:33.301 --> 00:16:40.163
So imagine this you've got a 52 year old woman with diabetes, high cholesterol and fatigue.
00:16:40.163 --> 00:16:41.668
She's on five medications.
00:16:41.668 --> 00:16:43.312
What would your process look like?
00:16:43.914 --> 00:16:46.380
She's on five medications for everything.
00:16:46.380 --> 00:16:50.525
I believe again, everything has a timeline.
00:16:50.525 --> 00:16:58.697
So if you're well managed on your five, my questions will be what are we doing in your lifestyle?
00:16:58.697 --> 00:17:04.313
So how are we approaching things from a nutrition standpoint, a food standpoint?
00:17:04.313 --> 00:17:06.567
What are you eating every day?
00:17:06.567 --> 00:17:08.086
How much water do you have?
00:17:08.086 --> 00:17:10.889
What is your general mental state?
00:17:10.889 --> 00:17:13.884
What's your attitude about diabetes?
00:17:13.884 --> 00:17:16.109
Do you think you can actually reverse this?
00:17:16.109 --> 00:17:17.921
Have you heard of people reversing this?
00:17:17.921 --> 00:17:19.824
Same for your cholesterol?
00:17:19.824 --> 00:17:22.871
What are your thoughts on plant-based diets?
00:17:22.871 --> 00:17:34.724
Is there a nutritionist or an amazing specialist I know, like Dr Tamar, who can guide you through the process of this and help you get to those goals holistically?
00:17:35.466 --> 00:17:46.613
I will ask questions to assess buy-in, because not everyone is fully on board with that and some aren't really given the tools right, which I know you do.
00:17:46.613 --> 00:17:52.033
But people don't always know that there's an option and sometimes I feel Western medicine.
00:17:52.033 --> 00:17:56.369
We don't always embolden and give people the power to take those steps.
00:17:56.369 --> 00:18:06.204
We tell them we should do diet and exercise, but we don't guide them through that process and it's a huge opportunity and gap in our care.
00:18:06.204 --> 00:18:12.057
I'm not an expert in all those things, so I generally would refer or partner with people that can fill in the gaps where I can't.
00:18:12.057 --> 00:18:13.951
But the number one thing I'm not an expert in all those things, so I generally would refer or partner with people that can fill in the gaps where I can't.
00:18:14.300 --> 00:18:17.350
But the number one thing I'm going to ask is how are you moving?
00:18:17.350 --> 00:18:18.866
How are you keeping active?
00:18:18.866 --> 00:18:20.467
How are you keeping your mind busy?
00:18:20.467 --> 00:18:27.592
What's good for the heart is good for your brain, and I'm going to want to know you know what types of exercise are you employing?
00:18:27.592 --> 00:18:29.344
You know what meds are you on?
00:18:29.344 --> 00:18:31.831
If it's five, okay, we can work with five.
00:18:37.640 --> 00:18:39.967
What does your blood pressure or cholesterol look like without the blood pressure medicine or statin?
00:18:39.967 --> 00:18:40.508
Is it still at goal?
00:18:40.508 --> 00:18:49.749
Are we doing this for cardiovascular purposes or are we doing this just because someone said you had diabetes and the guidelines quote unquote say you have to be on a statin for the rest of your life?
00:18:49.749 --> 00:19:03.714
These are the type of ways we kind of roll back some of the guidelines and really get to the nitty-gritty and see is this actually applicable for our patient in front of us, versus everyone painted with a broad pen?
00:19:03.714 --> 00:19:17.500
So once we have all that in mind and get the buy-in, we kind of assess what meds they're on, all that in mind and get the buy-in, we kind of assess what meds they're on, we start looking at goals and we start looking at some of the behavior and lifestyle pieces that we could switch up.
00:19:17.500 --> 00:19:19.868
So that's how I usually start that.
00:19:19.868 --> 00:19:22.537
So I like to see one are the meds necessary?
00:19:22.537 --> 00:19:23.240
Are they appropriate?
00:19:23.240 --> 00:19:24.222
Have we attempted a drug holiday?
00:19:24.222 --> 00:19:36.926
If they are well managed, with one or two meds over a couple months, and then we kind of methodically go through each and see if they are well managed with one or two meds over a couple months and then we kind of methodically go through each and see if they're maintaining that lifestyle change, if they don't need them anymore.
00:19:37.489 --> 00:19:38.614
I love that, dilan.
00:19:38.614 --> 00:19:46.523
I love that Definitely asking them questions to see where they are, what they've already been doing for their health and also their buy-in as well.
00:19:46.523 --> 00:19:50.973
How ready are they to possibly accept doing it a different way?
00:19:50.973 --> 00:19:55.064
How ready are they to possibly accept doing it a different way?
00:19:55.064 --> 00:19:57.669
And, of course, you're doing this alongside with the knowledge of their doctor as well.
00:19:57.669 --> 00:20:07.504
So similar approach is exactly what I do, and I take it a step further with the nutrition and the lifestyle changes by being the active guide for them for 90 days.
00:20:07.564 --> 00:20:16.192
I'm right by their side, helping them implement the recommendations that are in their Nutrigen omics report regarding the areas that they should really focus on.
00:20:16.192 --> 00:20:17.803
Is it a methylation issue?
00:20:17.803 --> 00:20:22.912
Potentially, is it an oxidative stress issue?
00:20:22.912 --> 00:20:26.763
Is it a blood glucose insulin regulation issue?
00:20:26.763 --> 00:20:41.804
The tests will identify that and then give them very specific nutrition recommendations, lifestyle recommendations, even exercise, like what type of exercises will be better for them and supplements that they could try.
00:20:41.804 --> 00:20:50.329
So I work with them for 90 days to implement that part that we're not really taught the details in pharmacy school.
00:20:50.329 --> 00:21:01.773
It's just yeah, make sure they're eating healthy, they're they limit if their heart failure are limited to X amount of sodium or, but you know, make sure you exercise, but we need.
00:21:01.773 --> 00:21:08.712
We don't get specific and then we send them off and unfortunately we do see for their physicians is physicians are doing the same thing.
00:21:08.712 --> 00:21:14.352
They're not necessarily referring them to a dietician or a fitness trainer.
00:21:15.261 --> 00:21:17.326
I've never seen a prescription for a fitness trainer.
00:21:17.868 --> 00:21:18.549
That'd be nice.
00:21:18.549 --> 00:21:19.512
It'd be nice.
00:21:19.512 --> 00:21:39.584
You know, social prescribing is a thing and we have some evidence where providers are starting to do more of that in England, you know, through the NHS are starting to do more of that in England, you know, through the NHS they're writing scripts to say, go walking with your friends or do some exercise X amount of days or time a week, and so it's showing results.
00:21:39.584 --> 00:21:40.706
It does work.
00:21:40.706 --> 00:21:45.743
So social prescribing can be a thing and I agree we got to have on it.
00:21:46.504 --> 00:21:51.084
I love that you also take a genomic approach, at times right With pharmacogenomics.
00:21:51.084 --> 00:21:52.428
Can you tell us about that?
00:22:01.100 --> 00:22:03.465
Yeah, yeah, huge fan of precision medicine and I like to offer it for those who want that finer look I offer to all.
00:22:03.465 --> 00:22:07.072
But not everyone has beds that really qualify, so to speak.
00:22:07.072 --> 00:22:14.866
But I think it's always nice to have, especially if in some instances it can be covered by your plan based on what you're on.
00:22:14.866 --> 00:22:20.644
So I like to use precision medicine or pharmacogenomics as a tool for deprescribing.
00:22:20.644 --> 00:22:31.252
A lot of times you get people with quote-unquote allergies and you go back in time and you start realizing, hmm, a lot of these are 2D6 pathway drugs or 2C19.
00:22:31.252 --> 00:22:34.630
And you start wondering hey, I wonder if there could be a genetic component here.
00:22:34.630 --> 00:22:48.691
And we've been able to unearth so many mysteries with quote-unquote coding allergies or morphine deficiencies or, you know antidepressants that they've failed multiple times just from having that panel done.
00:22:48.691 --> 00:23:01.730
And again it's the future of medicine is that we need to know what's going on at a cellular level, the genetic level and all the drugs that we're on aren't made for all of us equally right.
00:23:01.960 --> 00:23:05.608
Some are poorly responded in a certain population.
00:23:05.608 --> 00:23:07.908
You know, asian, black, white, what have you?
00:23:07.908 --> 00:23:14.232
People respond differently and that very much goes for how the medications may work.
00:23:14.232 --> 00:23:21.274
And with older adults, especially a more diverse, older population, there's no room for error.
00:23:21.274 --> 00:23:28.794
There's no room for just, you know, hoping that this works for an 80-year-old who's dealing with cognitive issues.
00:23:28.794 --> 00:23:31.167
We don't have time to just put people at risk.
00:23:31.167 --> 00:23:33.874
Old who's dealing with cognitive issues.
00:23:33.874 --> 00:23:35.419
We don't have time to just put people at risk.
00:23:35.439 --> 00:23:41.987
So I always, always, always ask patients and caregivers to advocate for this if they have medications that are actionable.
00:23:41.987 --> 00:23:44.713
So when we use these results, we get this beautiful report from our lab.
00:23:44.713 --> 00:23:47.730
We have all the medications in their portfolio.
00:23:47.730 --> 00:23:51.301
We're not only doing a DDI or drug interaction screen, but we're doing a pharmacogenetic interaction check as well.
00:23:51.301 --> 00:23:54.511
We're not only doing a DDI or drug interaction screen, but we're doing a pharmacogenetic interaction check as well.
00:23:54.511 --> 00:24:00.005
We're looking to see if there are any combinations of meds that may change the phenotype.
00:24:00.005 --> 00:24:01.669
Or how do people physically present?
00:24:01.669 --> 00:24:08.055
You can have multiple moderate or low responders and your phenotype you can present differently clinically.
00:24:08.055 --> 00:24:25.965
So knowing that, having a pharmacist's knowledge around that super critical when it comes to intense PGX drug-drug interactions, and they also are interactions with herbal medications too, so there are tons of ways that this can play a role, and I think pharmacists are the champion for it.
00:24:26.627 --> 00:24:28.070
Yeah, definitely, definitely.
00:24:28.070 --> 00:24:37.527
Pharmacogenomics is a powerful tool to use, especially I was want to say especially with polypharmacy, but just in general, just in general.
00:24:37.607 --> 00:24:47.594
Definitely knowing that your profile before a certain type of therapy is started can avoid so many side effects, ineffective treatments.
00:24:47.594 --> 00:24:59.273
I know I had a client that did pharmacogenomic testing in my program and she had been on a variety of antidepressants and each time ended up in the hospital.
00:24:59.273 --> 00:25:15.326
When we did that report she finally understood why she ended up in the hospital and she was in tears because she was like if the doctors had known that they could have done this test, I would have avoided those hospital visits and they would have started me on the one that the test is going to tell me it would work.
00:25:15.949 --> 00:25:18.961
Yeah, I hate hearing those stories, man.
00:25:18.961 --> 00:25:23.510
It's such a widely available tool but how?
00:25:23.510 --> 00:25:24.231
It just isn't.
00:25:24.231 --> 00:25:27.023
Because providers aren't really trained on it.
00:25:27.023 --> 00:25:30.813
There's still some unusual skepticism, although we've got decades of data.
00:25:30.813 --> 00:25:33.044
And then, of course, the implementation.
00:25:33.044 --> 00:25:35.572
There's just so many other clinical barriers.
00:25:35.572 --> 00:25:40.851
But honestly, guys, this is so easy to use, it's really not that difficult.
00:25:40.851 --> 00:25:56.511
It's great to have pharmacists and experts in this space, but we should not let patients fall victim because of quote-unquote confusion or negligence or a fear be unknown or new, and it's stories like that that have to break my heart.
00:25:56.511 --> 00:25:59.220
I mean it all could have been prevented.
00:25:59.220 --> 00:26:06.223
So how much money was wasted from all these re-admits, these hospitalizations, the quality of life that poor patient had?
00:26:06.223 --> 00:26:09.149
Again, we could do it a simple test.
00:26:09.149 --> 00:26:10.733
So totally agree.
00:26:11.113 --> 00:26:24.011
Yeah, I've heard practitioners say maybe I'm going off tangent on this, but they don't want to use the pharmacogenomic testing because there's not enough research, there's not enough randomized controlled trials supporting its use in X, Y and Z.
00:26:24.011 --> 00:26:47.374
And at some point you say real life, real life results kind of trump those studies sometimes you know when you actually test patients and apply the recommendations of those tests and you see the benefits and outcomes right in front of your face without a randomized controlled trial.
00:26:47.374 --> 00:26:49.047
I mean that speaks words.
00:26:49.620 --> 00:26:49.961
It does.
00:26:49.961 --> 00:26:56.433
You know all, because there isn't always a white paper on the stuff we do doesn't mean it's not working.
00:26:56.433 --> 00:26:59.582
And it's an interesting myth, right?
00:26:59.582 --> 00:27:06.663
Because if you want to really go down the rabbit hole, how many core trials do we use to approve FDA drugs?
00:27:06.663 --> 00:27:08.726
And we call that data.
00:27:08.726 --> 00:27:14.843
And yet you know, you know, oh, I've seen a thousand patients in a year who've all gotten better.
00:27:14.843 --> 00:27:17.852
If it's not published, you're a quack.
00:27:17.852 --> 00:27:18.394
So it's.
00:27:18.394 --> 00:27:22.144
It's interesting that spectrum of what we call data.
00:27:22.144 --> 00:27:24.648
But frankly, guys, catch up.
00:27:25.028 --> 00:27:32.051
The fda is mandating it for clinical trials, like they have fda guidelines and tables for actionable drugs.
00:27:32.051 --> 00:27:35.751
They were requiring pharma to report on PGX.
00:27:35.751 --> 00:27:52.086
There was an $800 million lawsuit because providers were not using PGX before prescribing Plavix and people unfortunately died from recurrent stroke because it was used in an Asian Pacific Islander population.
00:27:52.086 --> 00:27:58.722
There's reams of information where this has actionable work and, frankly, we've been doing it all the time.
00:27:58.722 --> 00:28:07.851
In oncology, how do you think we know the different types of positive cancer, ovarian breast cancer, receptors, all that stuff is genetics-based people.
00:28:07.851 --> 00:28:12.131
So this isn't made up, this is real and it's not going away.
00:28:17.222 --> 00:28:20.351
I know you created a training program for healthcare professionals.
00:28:20.351 --> 00:28:26.893
Can you tell us more about the Deprescribing Accelerator and how it's helping other professionals make this deprescribing shift?
00:28:27.739 --> 00:28:27.920
Yeah.
00:28:27.920 --> 00:28:38.331
So you know, in my journey of starting Geriatrics, I founded this company in 2020 and really went 10 toes down into deprescribing.
00:28:38.331 --> 00:28:39.641
Didn't know where this would lead me.
00:28:39.641 --> 00:28:40.824
I said you know what?
00:28:40.824 --> 00:28:51.131
I'm going to create a cash-based model around helping caregivers and older adults manage meds and advocate alongside with them, with their medical team.
00:28:51.131 --> 00:28:53.195
And starting my practice.
00:28:53.195 --> 00:29:01.143
You know I wanted to get better at what I was doing, and so I started researching the world of deprescribing.
00:29:01.143 --> 00:29:30.407
Like you have to be prescribing clinical trials, and so, in compiling all this literature and it ranges from studies from Australia, canada, the US, europe all types of people are heavy in the de-prescribing literature so I decided to create a course where I compiled not only all of these clinical findings, but I also fused it with some of the business lessons I've learned in creating this practice.
00:29:30.407 --> 00:29:39.092
And so 2022 was when I launched our very first cohort, and when I built this, I said you know what?
00:29:39.753 --> 00:29:48.209
Yeah, de-prescribing is important and, yeah, we as pharmacists, know the drugs the most, but everyone should know what de-prescribing is right.
00:29:48.209 --> 00:29:55.634
Every clinician should know and, frankly, our caregivers, who are thrust in the middle of managing all their loved ones' needs.
00:29:55.634 --> 00:29:58.424
They also should have an idea of what deprescribing is.
00:29:58.424 --> 00:30:02.558
So I created this program to be totally interdisciplinary.
00:30:02.558 --> 00:30:09.026
People can take our program over a year's time and they'll get 15 hours of live CE.
00:30:09.026 --> 00:30:19.606
And it includes pharmacists, social workers, nurses, pas, mds, dos all can receive credit on de-prescribing.
00:30:19.606 --> 00:30:25.794
And so it's called the de-prescribing accelerator because I want you guys to put this into practice today.
00:30:25.794 --> 00:30:27.587
I don't want this to be a buzzword.
00:30:27.587 --> 00:30:29.206
There are no more excuses.
00:30:29.206 --> 00:30:46.826
You're going to get all the tools, all the blueprints, all the clinical data that I've found out there, from deprescribingorg to the stop-start criteria, the beers list all tons of explicit and implicit tools clinicians can use to deprescribe.
00:30:46.826 --> 00:30:54.623
Some show a cost savings, some show quality of life improvement, and we cover trials from all over the world.
00:30:54.743 --> 00:30:55.966
So I figured you know what.
00:30:55.966 --> 00:30:57.571
I looked at all this stuff up.
00:30:57.571 --> 00:30:58.665
I've learned the literature.
00:30:58.665 --> 00:31:01.278
I've learned the researchers became cool with them.
00:31:01.278 --> 00:31:09.214
Let's give people a cheat sheet to put this into practice and stop finding reasons to not deprescribe.
00:31:09.214 --> 00:31:16.454
So it just blew my mind how much stuff was growing and the feel itself, you know, is blowing up.
00:31:16.454 --> 00:31:18.065
So I said let's do it.
00:31:18.065 --> 00:31:19.265
So 2022 came.
00:31:19.541 --> 00:31:20.839
We had our first few cohorts.
00:31:20.839 --> 00:31:25.460
We've trained over about 25 people over the last two, three years.
00:31:25.460 --> 00:31:30.853
We keep our cohorts kind of small, deliberately to give more quality and time to our clients.
00:31:30.853 --> 00:31:33.862
And yeah, we've helped pharmacists all over the country.
00:31:33.862 --> 00:31:36.930
We've helped nurses get their voice for deprescribing.
00:31:36.930 --> 00:31:44.203
We've helped one doctor who does caregiver research come up with ideas to create a caregiving manual for deprescribing.
00:31:44.203 --> 00:31:46.630
So the impact is there.
00:31:46.630 --> 00:31:50.231
We've had people go fully into their yoga practice.
00:31:50.231 --> 00:31:55.168
We've had some become diabetic, whole health coaches and use tools from our class.
00:31:55.168 --> 00:32:04.608
And there are those who are in practice and kept their job, who felt better as consultant pharmacists and advocating for their people in their long-term care facilities.
00:32:04.608 --> 00:32:06.928
So I'm loving all my students.
00:32:06.928 --> 00:32:07.783
I'll brag on them.
00:32:07.783 --> 00:32:15.366
But it's been really a blessing to see how this program has helped shape people's careers and their trajectory and, more importantly, their passion.
00:32:16.322 --> 00:32:17.406
Oh, that's awesome, Delon.
00:32:17.406 --> 00:32:23.653
I love that you put a lot of work into this to just to make sure ultimately for the patient, because you're only one person.
00:32:24.602 --> 00:32:27.075
You're only one person, you're only one person.
00:32:27.095 --> 00:32:40.273
So with the Accelerator, you're able to teach other professionals who are in direct contact with patients who need this help, need to make sure that they're safely taking these medications and not on unnecessary medications.
00:32:40.273 --> 00:32:43.346
They're right there on the front lines with them.
00:32:43.346 --> 00:32:47.547
So who better to train how to do what you're doing than those who have direct contact with these patients?
00:32:47.547 --> 00:32:48.986
So who better to train how to do what you're doing than those who have direct contact with these patients?
00:32:48.986 --> 00:32:52.153
So kudos to you for creating the Deep Prescribing Accelerator.
00:32:52.153 --> 00:32:53.363
It's very much needed.
00:32:53.383 --> 00:32:54.666
Thank you, it's been fun.
00:32:55.448 --> 00:32:56.470
Now let's zoom out a bit.
00:32:56.470 --> 00:33:01.528
You know we both had a lot to do when it comes to unlearning on our journey.
00:33:01.528 --> 00:33:04.634
If you could redesign pharmacy education.
00:33:04.634 --> 00:33:10.628
What's one thing you make sure every future pharmacist learns?
00:33:11.270 --> 00:33:16.343
man we getting after hours now, okay, we're gonna some feathers.
00:33:16.343 --> 00:33:18.246
I love that question.
00:33:18.246 --> 00:33:20.290
There's a lot of unlearning.
00:33:20.290 --> 00:33:31.014
I would say people skills are probably the most important thing to learn, like how how to talk to all people, not just the people that look like you.
00:33:31.014 --> 00:33:55.110
I think there should be an immersion into cultures as a part of pharmacy school, like understanding spiritual beliefs, multicultural impact, spiritual beliefs, multicultural impact and I would even say further, the history of medicine and how disenfranchised communities are still reeling from that.
00:33:55.691 --> 00:34:08.025
And thinking you come in with your fancy degree is going to change decades of history is going to be a huge piece of humble pie is going to be a huge piece of humble pie.
00:34:08.025 --> 00:34:36.786
So I think having immersion, rotations of students in these different cultural settings, these demographics, is the best way to teach people how to talk to different people, because language is very important and in order to have better outcomes with your patients or clients, you have to have a foundation of trust and empathy and sometimes medicine loses that sight.
00:34:36.786 --> 00:34:39.612
You know of having a common touch.
00:34:39.612 --> 00:34:40.902
Yes, you have a doctorate.
00:34:40.902 --> 00:34:42.003
That's brilliant, but do you not talk to someone?
00:34:42.003 --> 00:34:43.266
But do you know how to talk to someone?
00:34:43.266 --> 00:34:46.472
And if you can't relate or talk to someone.
00:34:46.472 --> 00:34:53.894
It's going to be difficult in the real world to get the impact you're looking for, and that's just one.
00:34:53.914 --> 00:34:54.460
I think there's a lot more.
00:34:54.460 --> 00:34:55.565
What's your number two?
00:34:56.519 --> 00:35:21.123
Number two, I would say to own your gift, and it's not meant to be cheesy, it's meant for you to be confident that your role is so critical, and I think we are sometimes seeking validation from teachers, from the Rokai or whoever is doing quote unquote better or has the best job.
00:35:21.123 --> 00:35:33.809
But you've got to work in a way that lets you be rugged in your uniqueness and your gift and it has to feel your passion.
00:35:33.809 --> 00:35:43.650
We do things oftentimes to keep up with the Joneses, or you're told to do this when you're 20, or your dad was a pharmacist, so I'm a pharmacist.
00:35:43.650 --> 00:35:49.760
Whatever the thing is, align what you want to do in this world.
00:35:49.861 --> 00:35:53.128
I don't care if it's doing hair, I don't care if it's painting.
00:35:53.128 --> 00:35:55.682
Align your passion to what moves you.
00:35:55.682 --> 00:36:00.733
If you don't live a life that's moving you, what is really the point of living?
00:36:00.733 --> 00:36:05.907
And I think God has given us all these talents to be shared.
00:36:05.907 --> 00:36:11.695
So if you can align that and it can be done with pharmacy it could be done outside of pharmacy.
00:36:11.695 --> 00:36:14.307
But don't just do things just because.
00:36:14.307 --> 00:36:22.371
Do it because it truly moves you and that's going to guide you, frankly, in your profession and in your just well-roundedness as a person.
00:36:23.073 --> 00:36:25.086
I concur that is so true.
00:36:25.086 --> 00:36:27.072
You have to do what moves.
00:36:27.072 --> 00:36:30.646
You do what you're passionate about, otherwise you're not going to enjoy it.
00:36:30.646 --> 00:36:33.822
You're not going to enjoy it, and I see that a lot with colleagues.
00:36:33.822 --> 00:36:36.829
Yeah, my dad was a pharmacist.
00:36:36.829 --> 00:36:42.443
I had to be a pharmacist or a doctor, so I chose one.
00:36:42.443 --> 00:36:47.153
But this is not your passion and they are miserable day to day, every day, at work.
00:36:47.153 --> 00:36:54.244
So make sure you're choosing your passion and going back to your first one with learning how to talk to people.
00:36:54.244 --> 00:36:56.729
Whether we want to hear it or not.
00:36:56.729 --> 00:37:00.655
As health care professionals, we are providing a service to humans.
00:37:01.280 --> 00:37:04.490
We have to learn how to humanize and how to talk to people.
00:37:04.490 --> 00:37:07.981
This is a service for them that we are offering.
00:37:07.981 --> 00:37:10.227
We're in a business, we're in a service business.
00:37:10.227 --> 00:37:37.977
So, yes, learning how to talk to people, educating yourself, or if a pharmacy curriculum on learning the history of healthcare and how it impacted different races, and just having that base knowledge, that basic knowledge will, I believe I agree with you would make a difference in how we approach, how many of us approach our patients and speak with them and how empathetic we are with them, instead of being so judgmental.
00:37:37.977 --> 00:37:42.530
Because I see it, I see it, yeah, you're non-compliant, you're non-adherent.
00:37:42.720 --> 00:37:44.544
It's like, well, did you talk to them?
00:37:44.544 --> 00:37:47.872
Do you know why do you have you related to them?
00:37:47.872 --> 00:37:50.265
Or you just listen to the chart?
00:37:50.265 --> 00:37:51.166
That the notes?
00:37:51.166 --> 00:37:52.871
You know that everyone copied and pasted.
00:37:53.052 --> 00:38:02.826
I don't know and in a hospital setting, I see patients suffering from pain sickle cell not being treated for their pain efficiently because they're pain seeking.
00:38:02.826 --> 00:38:06.735
No, they need to be treated for pain.
00:38:06.735 --> 00:38:10.244
So education along those lines is very, very important.
00:38:10.244 --> 00:38:15.483
So those are two great points that you mentioned that every future pharmacist should learn.
00:38:15.483 --> 00:38:17.387
So thank you for sharing your thoughts on that.
00:38:17.387 --> 00:38:23.407
Now, you know, we both carved out our lanes and it hasn't always been easy.
00:38:23.407 --> 00:38:24.329
We're entrepreneurs.
00:38:24.329 --> 00:38:26.934
That journey is not an easy one.
00:38:26.934 --> 00:38:34.213
People might look at us and not see the jagged line to get to where we are.
00:38:34.941 --> 00:38:36.023
And we're still on that path.
00:38:36.023 --> 00:38:47.771
It's a journey it doesn't end, so could you, if you don't mind, sharing Delon what's been the most challenging part of this journey of disrupting the pharmacy mold, and what's been the most impactful of this journey of disrupting the pharmacy mold and what's been the most difficult?
00:38:48.180 --> 00:38:49.526
Yeah, it's a great question.
00:38:49.526 --> 00:38:55.823
Multiple lessons along the way, goodness gracious For me.
00:38:55.823 --> 00:39:05.905
In the beginning I was egotistically translating me being a pharmacist to having success in the business.
00:39:05.905 --> 00:39:11.590
This can't be hard, I can do this, and the humble pie came very quick with that.
00:39:11.590 --> 00:39:20.740
I don't know what the hell I was doing in the beginning, and I learned quickly to invest in those that did so.
00:39:20.740 --> 00:39:34.794
Hiring coaches, hiring mentors helped me get unstuck, and so the biggest hurdle for me was the mindset shifting.
00:39:35.322 --> 00:39:53.611
Everyone kind of says that, but no, seriously, there is a level of the laws of attraction, and having the universe conspire towards your dreams is a very real thing and you have to believe it with every inch and fiber of your being.
00:39:53.611 --> 00:40:05.039
When you look in the mirror and wake up, you're doing something that lights you up and I feel in alignment with the divine, with the creator, with the universe, with your purpose.
00:40:05.039 --> 00:40:10.972
Right, the ikigai factor, the Japanese expression of living in your life's purpose.
00:40:10.972 --> 00:40:19.721
So being someone used to doing good and having the decent grades and things going relatively well.
00:40:19.721 --> 00:40:25.273
When things weren't going well, the hard part was killing that ego.
00:40:25.273 --> 00:40:33.307
There had to be an ego death in my first two years of business and the ego death came real.
00:40:33.307 --> 00:40:41.913
It showed in how I was treating my girlfriend, or neglecting my girlfriend at the time, or my dog.
00:40:41.913 --> 00:40:51.343
My own health I wasn't sleeping, my own health, I wasn't sleeping.
00:40:51.343 --> 00:40:55.436
I was just obsessed with the clicks on my website or the likes I got from a post you know like.
00:40:55.436 --> 00:40:57.662
So realizing, yes, you're in a business, you got to make it work.
00:40:57.822 --> 00:41:17.286
But the number one hurdle was the mindset shifting of the ego one and then the mindset of believing this is going to work and it's going to work beyond my wildest dreams, and making that an everyday thought, despite the wins, the losses, the lessons.
00:41:17.286 --> 00:41:22.485
And then you start learning that everything that happens is a lesson and not a failure.
00:41:22.485 --> 00:41:24.689
And, frankly, failures are all lessons.
00:41:24.689 --> 00:41:26.153
Right, that's your best teacher.
00:41:26.153 --> 00:41:35.594
So it's changing from that perfectionist mindset to the acceptance and letting things be.
00:41:35.594 --> 00:41:44.905
And the grace the hardest part was the grace for oneself on the journey is I have a habit of beating myself up if things go wrong.
00:41:44.905 --> 00:41:48.825
I'm like all right, well, I failed, I'm not trying that again.
00:41:48.825 --> 00:41:58.112
And you realize you're delaying your lesson or your reward because you gave in to the fear or the fear of failure.
00:41:58.112 --> 00:42:08.251
So multiple little nuggets in that, but those are some of the meaningful and distressing parts of being in business for sure.
00:42:08.760 --> 00:42:11.026
Definitely relatable, dr Canterbury.
00:42:11.026 --> 00:42:13.472
The death of the ego Wow.
00:42:13.472 --> 00:42:19.313
So I never heard it phrased that way and that alone is just powerful and says so many things.
00:42:19.313 --> 00:42:43.603
Definitely, mindset is important on a journey like ours, where we are, in essence, going against the grain in some aspects of within our profession and adjusting that mindset to remind ourselves that what we are doing is important and always remembering why we're doing it in the first place and who we're doing it for, number one.
00:42:43.603 --> 00:42:50.945
So I'm glad that you have come around to to adjust in the mindset, but it's something that's going to be continuous as well.
00:42:50.945 --> 00:42:53.030
Right, we're always going to have to have that shift.
00:42:53.641 --> 00:43:00.108
Like you, I have the natural tendency to beat up on myself if things don't work out, but I have learned as well that you know you just got to keep on going.
00:43:00.108 --> 00:43:01.661
How can I do things differently?
00:43:01.661 --> 00:43:02.762
What can I adjust?
00:43:02.762 --> 00:43:07.713
But what always pulls me back is remembering my why that I'm out here to.
00:43:07.713 --> 00:43:14.642
I'm doing this not for myself, but because I really want to help people learn a better way, a safer way.
00:43:14.642 --> 00:43:18.271
I want people to have that quality of life that they deserve.
00:43:18.940 --> 00:43:31.968
That's what makes you so awesome, honestly, is you bring that and it shows in your work and your commitment to your clients, to your peers, your colleagues like myself, I mean guys.
00:43:31.968 --> 00:43:42.425
That's what it's about, your why, and that's why it's so important to have that alignment and passion embedded and when you have those dark days, you have that reminder to pull you back to reality.
00:43:42.425 --> 00:43:44.050
So thank you for what you do in creating this platform.
00:43:44.050 --> 00:43:46.695
Well, you're welcome and thank you for what you do in creating this platform.
00:43:47.157 --> 00:43:48.039
Well, you're welcome.
00:43:48.039 --> 00:43:50.869
Thank you for joining me on this platform Before we go.
00:43:50.869 --> 00:43:55.144
It wouldn't be a Pivoting Pharmacy episode without this one.
00:43:55.144 --> 00:43:58.967
How are you raising the scripts on healthcare, dr Canterbury?
00:43:59.539 --> 00:44:00.987
Raising the scripts.
00:44:00.987 --> 00:44:06.977
I want deprescribing to be the most household name in the world in all of healthcare.
00:44:06.977 --> 00:44:07.757
I want itrescribing to be the most household name in the world in all of healthcare.
00:44:07.757 --> 00:44:22.407
I want it to be synonymous with getting old and I want everyone to know the power of asking when and how can I stop one or two of my meds alone.
00:44:22.407 --> 00:44:45.084
It's just reshifting decades of marketing and research and pharma jargon and, all frankly, what we believe to be the only way to heal, to teach people that are other avenues of healing and there's room for all okay.
00:44:45.084 --> 00:44:48.983
So I want that to be the answer for people who are faced with quality of life issues, who are concerned caregivers and don't know.
00:44:48.983 --> 00:44:52.952
People like Dr Jamar or myself can help them with a quick call.
00:44:54.340 --> 00:44:59.251
I think we need resources in communities that likely don't have access to this.
00:44:59.251 --> 00:45:02.244
So asking that question doesn't take a degree.
00:45:02.244 --> 00:45:05.351
It's literally hey, I think I'm on too many meds.
00:45:05.351 --> 00:45:06.492
Where can we start?
00:45:06.492 --> 00:45:08.322
Have a conversation.
00:45:08.322 --> 00:45:10.807
Don't be afraid to ask why.
00:45:10.807 --> 00:45:14.693
Don't be afraid to question if this is still necessary.
00:45:14.693 --> 00:45:17.124
That's to me, deep prescribing.
00:45:17.124 --> 00:45:21.113
It's not as didactic and clinical of having a degree in it.
00:45:21.113 --> 00:45:22.262
It's simple stuff.
00:45:22.262 --> 00:45:24.467
Is this absolutely vital for me to live.
00:45:24.467 --> 00:45:26.532
Is it important for my quality of life?
00:45:26.532 --> 00:45:33.604
If it's not either of these two, do you really need it?
00:45:33.624 --> 00:45:34.126
Ask those questions.
00:45:34.126 --> 00:45:35.009
So that's what I want for everybody.
00:45:35.009 --> 00:45:35.209
I love it.
00:45:35.209 --> 00:45:36.835
Ask those questions, it goes both ways.
00:45:36.835 --> 00:45:39.362
Whether we are the pharmacist, ask the question.
00:45:39.362 --> 00:45:41.507
If we're the patient, ask the question.
00:45:41.507 --> 00:45:42.670
Don't be afraid.
00:45:42.670 --> 00:45:43.920
Take control of your health.
00:45:43.920 --> 00:45:48.682
I know I always say I tell my clients you are the boss of your doctor.
00:45:49.663 --> 00:45:58.809
You keep them employed, so view yourself as the boss, and as the boss, you have every right to know why and what, and you really need it.
00:45:58.809 --> 00:45:59.809
So ask the questions.
00:45:59.809 --> 00:46:03.872
Don't be afraid, because so many get intimidated by those in the white coats.
00:46:03.872 --> 00:46:05.172
Well, that's the doctor.
00:46:05.172 --> 00:46:06.173
I have to do what they say.
00:46:06.173 --> 00:46:08.755
You can ask questions, very important.
00:46:08.755 --> 00:46:13.077
Well, dr Canterbury, this was everything I hoped episode 100 would be.
00:46:13.077 --> 00:46:21.572
Thank you for showing up not just as the deprescribing pharmacist, but as a true friend, colleague in this work and to our listeners.
00:46:21.572 --> 00:46:29.244
If you're a patient thinking maybe I don't need all these meds, or a provider wanting to go deeper, check out our links in the show notes.
00:46:29.244 --> 00:46:36.190
Whether you're ready to personalize care of genetics or learn more about safety prescribing, we're here to help Talk to you next Friday.
00:46:36.190 --> 00:46:42.561
Until then, always remember to raise the script on health, because together we can bring healthcare to higher level.