A new approach to prescribing — and de-prescribing — medications

As he builds his pharmaceutical career to serve as an advocate for older adults, DeLon Canterbury is focused on helping to educate people about what they need and don’t need when it comes to medication.

And data shows that older adults consume a lot of medication. According to the Centers for Disease Control (CDC), use of five or more prescription drugs (defined as polypharmacy) was more common among adults aged 60–79 compared with those aged 40–59 in both the United States (34.5% versus 14.5%) and Canada (30.9% versus 10.4%).

At 35, Canterbury, the founder of GeriatRx, is looking at the bigger picture: “I’d like to see us redefine the standard of aging to require de-prescribing as the standard of care for all people and I think it should be on all fronts,” he said. “It should involve the caregiver, the patient, the provider. I think there needs to be a fundamental understanding that medications in this population, in this environment, in this climate, in this country, where we love to over-prescribe; well, you can assume there’s something going on behind the scenes.”

He continued, “If we don’t think of pharmacists as the perfect segue to address this problem, we’re going to have more and more people falling victim to meds that we think are doing good. So when you ask me about my vision, it’s to change the standard of practice.”

Next Avenue asked DeLon Canterbury to tell us more about the role of the pharmacist as he sees it, and how a very personal example inspired him to provide better care for older adults.

This interview has been edited for length and clarity.

My grandmother had mild dementia and was given an inappropriate medication to manage her care — it was an antipsychotic. At the time, she was living in an assisted living facility. The medication unfortunately just spiraled her condition out of control; we had to move her from New York down to Georgia where I grew up.

At the time, I was just finishing up my last few months at Emory University. For me, as someone who was pre-pharmacy, I was trying to figure out why Granny was getting worse. She was wandering around the house, hiding her dentures, hiding her glasses and not remembering us. It was heartbreaking.

Eventually it was my mom, frustrated at a pharmacy refill, who vented to the pharmacist. They took an extra look and found that it was actually the medication that was causing her issues. We spent months just trying to figure out what was going on with my grandmother. And here I was, trying to get into the pharmacy [field] and seeing how we have a system where people are paying to slowly whittle away.

I was a bit emboldened, and I was furious that there wasn’t a holistic lens when it comes to treatment. I was tired of seeing countless people fall victim to being prescribed medicine that wasn’t right for them, especially people that look like me, people of color, in this population. So that struck a chord and led me not just to geriatric medicine, but to volunteering with more nonprofits around doing medication reviews and patient advocacy. That eventually led to the creation of GeriatRx.

Our focus is on medication deprescribing and med management using genetic testing for anyone who is looking to get an objective opinion on how to reduce their pill burden.

Clients connect with us, we do a medication review, and then if there are concerns that we want to address, we create a deprescribing action plan that the client can take to their health care provider. We can also communicate directly with the provider. Otherwise, we can create a “cheat code” that explains the issues we see with medication and how an individual, or their loved one, can advocate for changes.

For example, sometimes it could be a blood pressure medicine or a diabetic medicine that’s being used too much or maybe the person just has a change in their kidneys and the way they clear that drug just doesn’t work in the same way. Where I come in as a pharmacist is to look at not just the pharmacology of things, but what are the side effect profiles best matched to what the patient may be taking.

Caregivers have been the driving force behind our business because they are the ones who are usually the most concerned about those medication lists. To me, their voices are underrepresented in this health system — they really are the ones with the boots on the ground, seeing issues with their loved ones firsthand. I think pharmacists are the perfect advocates for [caregivers] — they can have their own “concierge” in their pocket who can say, you know what? You’re right, your suspicion about the medication is right. We partner with nonprofit groups and caregiving advocacy groups, like area agencies on aging, to act as a resource.

Ageism is insidious in medicine, period. We pretend in this country that we care; there are people who are doing great things [in the health field] but as a society, we do not care [about older adults]. I just think there’s so much we don’t respect — we are quick to deflate someone’s opinion because they are of a different era. We have unconscious biases.

I do think there is a lack of empathy in how older adults are treated. They should be the most respected and revered people in the community — I’ve seen that in other parts of the world, and also in my Caribbean upbringing.