[Deprescribing in older patients: how to proceed in practice?]

Polypharmacy is common in older people and may have numerous consequences, including adverse drug reactions, drug interactions, hospitalizations and loss of independence. Deprescribing should be considered as soon as a treatment is started and carried out on the basis of a comprehensive geriatric assessment. Tools such as the Beers criteria and STOPP/START (Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert to Right Treatment) help identify potentially inappropriate medications, while others, such as the deprescribing.org website, provide deprescribing protocols. Deprescribing stems from a shared decision between the patient, the physician in charge and, if needed, the clinical pharmacologist. Its success rests on an individualized plan and on regular follow-up, to identify and anticipate possible withdrawal symptoms.