How case managers can support medication change

A practical guide to supporting deprescribing and medication adjustments in injury recovery

Published: 3 April 2026 | Updated: 3 April 2026

Why medication change matters in your role

As a case manager, you navigate complex recovery journeys where medication often plays a critical role. Yet medication change is frequently overlooked despite its significant impact on claimant outcomes. When your claimant's medication regimen is excessive, inappropriate, or unsustainable, it creates barriers to return to work, extends recovery timelines, and increases claim costs.

Supporting medication change, particularly deprescribing (the intentional reduction of unnecessary medications), is increasingly recognised as essential case management practice. Your role is not to prescribe or recommend specific changes, but to facilitate conversations, remove barriers, and ensure your claimant has access to proper clinical guidance.

Understanding deprescribing in the injury context

Deprescribing is the systematic reduction or cessation of medications no longer needed or causing harm. In injury claims, this often involves reviewing sedating medications, antidepressants with marginal efficacy, polypharmacy arrangements that lack clear clinical indication, or medications prescribed outside the injury-related condition.

Successful deprescribing requires careful planning, clinical oversight, and claimant engagement. Your value as a case manager is creating the conditions for deprescribing to happen safely. This means:

• Identifying when medication review would benefit your claimant
• Arranging clinical pharmacy assessment where appropriate
• Managing expectations around timelines for medication change
• Monitoring for withdrawal effects or rebound symptoms
• Reinforcing the link between medication optimisation and functional goals

Recognising medication barriers in your caseload

Effective case management starts with identification. Watch for these indicators that medication change may benefit your claimant:

Facilitating medication review conversations

When you've identified a potential medication issue, your approach matters. Claimants often feel defensive about medications they depend on, even when those medications are problematic. Frame medication review as part of optimising their recovery, not as criticism of their current management.

How to initiate the conversation

Working with pharmacy professionals

Clinical pharmacists have specialist expertise in medication optimisation. They review the complete medication profile, identify drug interactions, spot redundancy, and recommend safe reduction strategies. When engaging pharmacy support:

• Provide complete medication history including over-the-counter products and supplements
• Share your claimant's functional goals and return-to-work timeline
• Highlight specific medication concerns (e.g., sedation limiting rehabilitation)
• Request clear recommendations your claimant's GP can implement
• Ask for a realistic timeline for medication changes
• Ensure recommendations address your claimant's personal concerns and preferences

Supporting your claimant through medication change

Medication reduction can feel risky to claimants who have relied on these substances. Your reassurance and consistent messaging are crucial:

• Explain the rationale: "These changes are designed to help you think more clearly and participate better in your rehab."
• Set realistic expectations: "Adjustment takes a few weeks. You might notice mood or sleep changes initially, but they usually settle."
• Establish monitoring: "Let's check in weekly while your medications are changing. Contact me immediately if you experience concerning symptoms."
• Reinforce goals: "This adjustment brings us closer to your return-to-work goal. We're making progress."
• Manage setbacks: "Some fluctuation is normal. Let's discuss with your GP before making any changes."

Documentation and communication

Strong case management of medication change requires clear documentation. Record:

• The specific medication concerns identified and why
• Date of medication review referral and provider contacted
• Recommendations received and approval from the claimant's prescriber
• Agreed timeline for medication changes
• Progress against the medication adjustment plan
• Any adverse effects or unexpected developments
• Impact on functional outcomes and recovery progress

Communicate proactively with the claimant's medical team. Send referral letters clearly outlining the medication concerns and recovery context. Follow up on recommendations and ensure prescribers understand the case management priorities.

Measuring success

How do you know medication change is working? Track these indicators:

• Increased participation in rehabilitation or vocational activities
• Improved functional capacity or pain-free activity levels
• Better sleep quality or mood stability
• Enhanced cognitive function or mental clarity
• Reduced pharmacy spend aligned with medication reduction
• Faster progress toward return-to-work goals
• Improved claimant satisfaction and engagement with recovery

Common challenges and solutions

Challenge: Claimant resistance to medication change because "it helps me sleep" or "my doctor prescribed it."

Solution: Reframe the conversation around recovery goals. "I understand the sleep help. Let's see if we can improve sleep through other means like exercise or sleep hygiene while reducing the medication side effects affecting your thinking."

Challenge: Medical providers reluctant to deprescribe due to fear of symptom return.

Solution: Emphasise the structured monitoring plan and the temporary nature of adjustment. Request a slow, controlled taper rather than abrupt cessation.

Challenge: Medication changes taking longer than expected recovery timeline.

Solution: Work with the medical team on accelerating the timeline where clinically safe. Sometimes faster tapers with close monitoring are appropriate in injury contexts with strong vocational timelines.

Your role in injury claim outcomes

Medication governance is increasingly recognised as a core case management competency. Your willingness to engage with medication issues, facilitate specialist assessment, and support evidence-based changes directly impacts claimant outcomes. This extends recovery, reduces long-term medication dependence, and ultimately improves return-to-work success.

By positioning yourself as an informed advocate for medication optimisation, you're not overstepping into clinical territory. You're doing what case managers do best: identifying barriers to recovery and coordinating the right expertise to address them.