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Polypharmacy and Deprescribing in Older Adults
Wade Thompson1,2, Emily G McDonald3,4,5
1Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;
Annual Review of Medicine
|September 20, 2023
Summary
Deprescribing, or reducing medications for older adults, is safe and feasible. Future research should focus on practical implementation strategies and optimal outcome measures for this essential aspect of personalized care.
Area of Science:
- Geriatrics
- Pharmacology
- Internal Medicine
Background:
- Older adults often take multiple medications, necessitating regular review.
- Deprescribing is a key component of individualized geriatric care.
- Medication regimens in older adults may not be reassessed for extended periods.
Purpose of the Study:
- To highlight the importance of deprescribing in older adults.
- To identify challenges and opportunities in deprescribing research.
- To emphasize the need for practical implementation strategies.
Main Methods:
- Review of existing evidence on deprescribing feasibility and safety.
- Analysis of challenges in deprescribing research, including outcome measures and contextual effectiveness.
- Examination of barriers and facilitators to deprescribing in clinical practice.
Main Results:
- Deprescribing is generally feasible and safe in older populations.
- Significant challenges exist in identifying optimal outcome measures for deprescribing.
- Effectiveness of various deprescribing approaches across different contexts remains uncertain.
- Barriers and facilitators significantly impact routine clinical deprescribing.
Conclusions:
- Deprescribing is a vital, yet complex, aspect of geriatric pharmacotherapy.
- Further research is needed to refine outcome measures and identify effective deprescribing strategies.
- Practical and sustainable implementation of deprescribing in routine care is a priority.
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