Dr. Canterbury’s mission for deprescribing stems from seeing the consequences of an inappropriately used medication prescribed for his grandmother, Mildred, who had mild dementia and was given the sedative Ziprasidone in an assisted-living facility. “For months we kept wondering why granny seemed more out of it and was declining with her cognition,” he said, adding that “it got to the point where my parents had to move her from New York to Atlanta,” where his parents took her into their home, where they had to start managing Mildred’s care. Dr. Canterbury reports that Mildred’s symptoms worsened with increased wandering, hiding of expensive valuables like dentures, and increased memory loss. Upon a medication refill several months later, a community pharmacist pointed out the Black Box Warning associated with the use of antipsychotics for managing dementia and realized that Mildred may be worsening due to the medication. “They advocated for our family by calling the doctor and having the medicine deprescribed over a few weeks, where Mildred returned to her baseline self,” Dr. Canterbury stated, adding “She died my last day of pharmacy school, but lived to see 90 years old because of this pharmacist.” This preventable experience infuriated Dr. Canterbury, and it was pivotal to his path leading him to become the “Deprescribing Pharmacist” and create GeriatRx to emulate the level of compassion, advocacy, and patient education around deprescribing to better serve older adults and their caregivers.
Dr. Canterbury is the founder and CEO of GeriatriRx, Inc., a concierge deprescribing telehealth-based service providing direct advice for patients, caregivers, and their care team in identifying high-risk medications and developing a “Deprescribing Action Plan” to help all parties navigate how to best implement Drug withdrawal and monitoring. “Providing a concierge service allows me to build meaningful relationships with all of my patients and caregivers, where several medication errors get unearthed from identifying when potential medication adverse events started. This is undoubtedly the happiest I’ve ever been in my career and personal life, where I am free to give objective, thorough, comprehensive, and life-saving advice that directly improves quality of life for both my patients and caregivers,” Dr. Canterbury proudly stated. A prime example of his success in this space involves GeriatriRx’s first patient—an overmedicated 70 year-old woman taking 36 prescriptions involving numerous prescribing cascades, polypharmacy, and duplicate therapies. “We were able to work with their PCP collaboratively and develop a plan, tapering her strategically down to just 8 medications over 2 months. This woman presented just like my grandmother, and was described as a ‘walking zombie’ by her caregiving daughter. She had severe memory loss, oversedation, and ate more of her medications than actual food in a day. We were able to bridge some of the gaps by providing continuity in care through medication reconciliation, and informing all of her specialists of the high-risk medications we identified as contributing to worsening her cognition. The PCP agreed with our plan, and subsequently, our patient is only on 3 medications.” Dr. Canterbury credits this intervention with saving the patient from a conservatorship and a costly involuntarily committal to a memory care unit. He reports that instead of that course of action, the successful “Deprescribing Action Plan” allowed her to stay at home with her daughter and age gracefully in place. Dr. Canterbury added, “Given the current monthly of cost of a memory care unit, we were able to save this family well over $500,000 in nursing home costs alone just from one deprescribing medication review. This renewed my passion for pharmacy, patient advocacy, and geriatric care, and inspired me to provide this service to more patients across the country! I was elated, grateful, humbled, inspired and motivated to keep doing the same thing globally!”
In USDeN, Dr. Canterbury has found a community of like-minded advocates committed to improving the quality of life for older adults by improving the body of research around deprescribing with new and compelling evidence. He said, “The amazing published and ongoing study projects USDeN supports and funds, along with the amazing network of professionals have helped me feel at home as a relatively new researcher within this space, coming from a primarily community pharmacist background. The deprescribing symposiums are immensely valuable to me and have helped me to make connections with key people across the country to put my thoughts into clinical implementation. I love that they provide grant opportunities as well for a mix of differing clinical settings.”
Dr. Canterbury continued to say that USDeN has been inspirational in his work, owing to USDeN’s professional networking and development opportunities. He said, “I’ve thoroughly enjoyed meeting passionate researchers, geriatricians, alongside Aging Advocates while attending the American Geriatrics Society along with the American Society of Consultant Pharmacists. Additionally, attending their pre-conference workshops and seminars allowed for close interaction with USDeN staff, cutting edge presentations from leaders in deprescribing across the world.” Dr. Canterbury stated that USDeN interactions—especially with peer pharmacists—have empowered, and he pointed to valuable insights about deprescribing with a health-equity lens, which was helpful when creating a current pilot study, “Addressing Deprescribing within AME Zion Faith-Based Communities with Multiple Chronic Conditions.”
Additionally, Dr. Canterbury received a mini-grant for $5,000 in partnership with Duke CERI, AME Zion HEAL on the first ever African-American focused deprescribing Initiative using faith-based communities and precision medicine. The project is titled “Deprescribing Educational and Clinical Intervention for Community-Dwelling Black Adults with Multiple Chronic Conditions in marginalized faith-based communities using Comprehensive Medication Management and the VIONE Methodology.”
Clearly, Dr. Canterbury is an exciting and innovative deprescribing advocate within USDeN, and we look forward to hearing more evidence- and research-based deprescribing implementation success stories from him in the future.
