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Deprescribing: a primary care perspective.

Polly Duncan1, Martin Duerden2, Rupert A Payne1

  • 1Centre for Academic Primary Care, University of Bristol, Bristol, UK.

European Journal of Hospital Pharmacy : Science and Practice
|June 4, 2019
PubMed
Summary
This summary is machine-generated.

Deprescribing, the supervised withdrawal of inappropriate medications, can mitigate problems from polypharmacy in primary care. Patient involvement and overcoming barriers are key to successful deprescribing strategies.

Keywords:
DeprescribingGeneral practiceMedication optimisationMedication reviewPRIMARY CAREPolypharmacyPrescribing

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Area of Science:

  • Primary Care Medicine
  • Geriatric Pharmacology
  • Medication Management

Background:

  • Polypharmacy presents a growing global challenge in primary care.
  • While sometimes necessary, polypharmacy can lead to adverse health consequences.
  • Deprescribing offers a strategy to manage inappropriate medication use.

Purpose of the Study:

  • To examine the process and considerations of deprescribing within the primary care setting.
  • To highlight the steps involved in safely withdrawing medications.
  • To emphasize the role of healthcare professionals and patient engagement.

Main Methods:

  • Review of medications and their indications.
  • Assessment of potential harms and eligibility for discontinuation.
  • Development of medication stopping plans with monitoring.
  • Consideration of patient involvement and end-of-life care contexts.

Main Results:

  • Deprescribing involves medication review, harm assessment, and planned discontinuation.
  • Patient support for deprescribing is generally high, but clinician attitudes vary.
  • Barriers to implementation exist for both patients and clinicians.

Conclusions:

  • Deprescribing is a complex but vital process for improving medication safety in primary care.
  • General practitioners are central to facilitating deprescribing, often collaborating with other healthcare professionals.
  • Further clinical trial evidence on deprescribing effectiveness and safety is essential.