Deprescribing: a primary care perspective

Polly Duncan, Rupert Payne, Martin Duerden

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)
350 Downloads (Pure)

Abstract

Polypharmacy is an increasing and global issue affecting primary care. Although sometimes appropriate, polypharmacy can also be problematic, leading to a range of adverse consequences. Deprescribing is the process of supervised withdrawal of an inappropriate medication and has the potential to reduce some of the problems associated with polypharmacy. It is a complex and sensitive process. We examine the issue of deprescribing from the perspective of primary care. Key steps in the deprescribing process are a review of medications and corresponding indications, consideration of harms, assessment of eligibility for discontinuation, prioritisation of medications and implementation of a stopping plan with appropriate monitoring. Patient involvement is a key feature of this process. Deprescribing should be considered in the context of end-of-life care and medication safety, but approaches are also required to identify other situations where deprescribing is appropriate. General practitioners are well positioned to facilitate deprescribing, usually through formal medication review, with decisions informed by a range of other healthcare professionals. Guidelines are available that help guide these processes. A range of studies have explored attitudes towards deprescribing; patients are generally supportive of the concept, although clinician views are varied. The successful implementation of deprescribing strategies still requires important patient and clinician barriers to be overcome, and clinical trial evidence of effectiveness and safety is essential.
Original languageEnglish
Pages (from-to)37-42
Number of pages7
JournalEuropean Journal of Hospital Pharmacy
Volume24
Issue number1
Early online date20 Dec 2016
DOIs
Publication statusPublished - Jan 2017

Keywords

  • polypharmacy
  • primary care
  • deprescribing
  • medication review
  • medication optimisation

Fingerprint Dive into the research topics of 'Deprescribing: a primary care perspective'. Together they form a unique fingerprint.

Cite this