Deprescribing in Complex Patients: A Pharmacologic Framework for APRNs

Course overview

As the healthcare landscape sees a rise in multi-morbidity and polypharmacy, the role of the Advanced Practice Registered Nurse (APRN) in medication optimization has never been more critical. This course offers a deep dive into the deprescribing process, moving beyond simple medication reconciliation to a proactive pharmacologic framework. We will analyze the 2023 AGS Beers Criteria and STOPP/START v3 updates to identify high-risk agents in older adults and those with limited life expectancy. Learners will gain practical skills in utilizing validated deprescribing algorithms for proton pump inhibitors, benzodiazepines, antihyperglycemics, and statins. By focusing on the "Prescribing Cascade" and the unique physiological vulnerabilities of complex patients, this course empowers APRNs to reduce medication burden, improve patient safety, and align pharmacotherapy with individualized goals of care. Learning Objectives By the end of this course, the participant will be able to: Analyze age-related changes in pharmacokinetics and pharmacodynamics that necessitate deprescribing in complex patients. Apply the 2023 AGS Beers Criteria and STOPP/START v3 to identify pharmacologic agents with an unfavorable risk-profile. Evaluate the physiologic mechanisms of the "Prescribing Cascade" to identify and resolve medication-related harms. Develop evidence-based tapering schedules based on the half-life and receptor-binding characteristics of psychotropic and gastrointestinal agents. Differentiate between the clinical presentations of antidepressant discontinuation syndrome and underlying disease recurrence.