Side effects nobody had mentioned

Hector Villanueva’s dizziness had been attributed to being seventy-four. It was in fact attributable to something he had started at seventy-one.

Reviews are booked annually and attended jointly with whoever manages the person’s medicines at home, which is frequently not the person themselves.

The fortnight gap

The call happens at day three and lasts as long as it needs to. The median is nineteen minutes; the longest recorded on this service is fifty-two.

Prescribing cascades start here — a side effect gets a diagnosis, and the diagnosis gets a medicine.

Ayesha Kalim, community pharmacy

Deprescribing, slowly

Deprescribing is done one agent at a time with a defined review window, and the patient holds a written record of what was stopped, when, and what to watch for.

One agent changed. The dizziness stopped in eleven days. “Three years,” he says. “Eleven days.”