Global InformationDeprescribing information
Deprescribing is a process of tapering or stopping medications to achieve improved health outcomes by reducing exposure to medications that are potentially either harmful or no longer required.[1] Deprescribing is important to consider with changing health and care goals over time, as well as polypharmacy and adverse effects.[2] Deprescribing can improve adherence, cost, and health outcomes but may have adverse drug withdrawal effects. More specifically, deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient's current situation.[3][4] Deprescribing can help correct polypharmacy and prescription cascade.
Deprescribing is often done with people who have multiple long-term conditions (multimorbidity), older people, and people who have a limited life expectancy.[5] In all of these situations, certain medications may contribute to an increased risk of adverse events, and people may benefit from a reduction in the amount of medication taken. Deprescribing aims to reduce medication burden and harm while maintaining or improving quality of life. "Simply because a patient has tolerated a therapy for a long duration does not mean that it remains an appropriate treatment. Thoughtful review of a patient's medication regimen in the context of any changes in medical status and potential future benefits should occur regularly, and those agents that may no longer be necessary should be considered for a trial of medication discontinuation."[6]
The process of deprescribing is usually planned and supervised by healthcare professionals.[7] To some, the definition of deprescribing includes only completely stopping a medication, while to others, deprescribing also includes dose reduction, which can improve quality of life (minimize side effects) while maintaining benefits.[8]
- ^ Page A, Clifford R, Potter K, Etherton-Beer C (April 2018). "A concept analysis of deprescribing medications in older people". Journal of Pharmacy Practice and Research. 48 (2): 132–148. doi:10.1002/jppr.1361. S2CID 56510472.
- ^ Quek HW, Page A, Potter K, Etherton-Beer C (April 2023). "Deprescribing considerations for older people in general practice". Australian Journal of General Practice. 52 (4): 173–180. doi:10.31128/AJGP-08-22-6547. PMID 37021442. S2CID 257984022.
- ^ Reeve E, Gnjidic D, Long J, Hilmer S (December 2015). "A systematic review of the emerging definition of 'deprescribing' with network analysis: implications for future research and clinical practice". British Journal of Clinical Pharmacology. 80 (6): 1254–1268. doi:10.1111/bcp.12732. PMC 4693477. PMID 27006985.
- ^ Thompson W, Farrell B (May 2013). "Deprescribing: what is it and what does the evidence tell us?". The Canadian Journal of Hospital Pharmacy. 66 (3): 201–202. doi:10.4212/cjhp.v66i3.1261. PMC 3694945. PMID 23814291.
- ^ Gnjidic D, Le Couteur DG, Kouladjian L, Hilmer SN (May 2012). "Deprescribing trials: methods to reduce polypharmacy and the impact on prescribing and clinical outcomes". Clinics in Geriatric Medicine. 28 (2): 237–253. doi:10.1016/j.cger.2012.01.006. PMID 22500541.
- ^ Linsky A, Simon SR (April 2013). "Reversing gears: discontinuing medication therapy to prevent adverse events". JAMA Internal Medicine. 173 (7): 524–525. doi:10.1001/jamainternmed.2013.4068. PMID 23459795.
- ^ Liacos M, Page AT, Etherton-Beer C (August 2020). "Deprescribing in older people". Australian Prescriber. 43 (4): 114–120. doi:10.18773/austprescr.2020.033. PMC 7450772. PMID 32921886.
- ^ Page A, Clifford R, Potter K, Etherton-Beer C (April 2018). "A concept analysis of deprescribing medications in older people". Journal of Pharmacy Practice and Research. 48 (2): 132–148. doi:10.1002/jppr.1361.