One of the most rewarding experiences in health care, for patients and health providers, is to stop a medication because a health condition has improved so much.
That is a regular occurrence for Dr. Vyvyane Loh, the Medical Director of Transform Alliance Health in Newton, MA. Almost daily she deprescribes medications for patients with chronic diseases who have improved their health with a suite of lifestyle changes.
“Most patients would rather be off daily drugs and restored to better metabolic health, but they need help to understand what to do. If you give patients relevant and motivating information, they are more than willing to make the lifestyle changes that can improve their health,” said Dr. Loh, who is board-certified in Obesity Medicine and Internal Medicine.
She has more than 20 years of experience helping patients lose weight, put type 2 diabetes into remission, improve cardiovascular and metabolic health and reverse/prevent other chronic diseases.
“My interest is in immuno-metabolism, body composition, and molecular pathways and how that all plays into complex chronic disease and chronic care.”
Dr. Loh will share her experiences and advice at the IPTN’s May webinar, entitled Deprescribing When Common Chronic Diseases are Put Into Remission. The webinar takes place Wednesday, May 1 at 5 pm Pacific time.
Dr. Loh notes that doctors are never taught how to deprescribe. The assumption is in medicine, especially around chronic disease management, that the condition will inevitably get worse over time, not better, and the physician will have to add medication. In addition, clinical practice guidelines instill fear and uncertainty that the doctor may be liable if they help pursue remission and medication removal because those options are not described in the standards of care.
“I am usually sent my patients from other doctors because they don’t know what to do,” says Dr. Loh.
In her May webinar, Dr. Loh will identify the common chronic diseases that can be treated for remission and the medications associated with their management, with a specific focus on diabetes, hypertension, and cardiovascular diseases. Dr. Loh will present practical tools and considerations when deprescribing or weaning patients off medications as they go into remission. She will also cover the management of symptoms in the transition period of medication withdrawal as well as discuss the possible pitfalls of deprescribing and when to refer patients to specialists.
Dr. Loh will also describe her process of assessing underlying health issues and educating and motivating patients to make effective changes, specifically around nutrition, exercise, sleep, and stress.
For example, every one of her patients gets a sleep study, whether they look like they need it or not.
“I don’t care if they are skinny and look healthy, I want to see how they are sleeping. I have had skinny people with severe sleep apnea. We are never going to correct their hypertension, and get them eventually off anti-hypertensives if we don’t correct their sleep.”
Dr. Loh is not only an accomplished physician with a medical podcast, she is an award-winning novelist and former dancer and choreographer. As a novelist she was the recipient of the Bunting/Radcliffe Fellowship in Fiction in 2006, a Guggenheim Fellow in Fiction in 2008, and shortlisted for the 2005 international IMPAC Award in Literature.
Her diverse skills support her commitment to celebrating the full range of our humanity in an increasingly technological and disembodied world through art and the healing sciences.
The webinar will be recorded. Please register here.
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