Deprescribing: Achieving Better Health Outcomes for Older People through Reducing Medications

Older people are prescribed a disproportionate number of medications. Polypharmacy leads to reduced compliance, increases the risk of adverse drug effects and may lead to poor medication outcomes. There is considerable evidence of inappropriate as well as excessive prescribing for older people. Although there are risks, medication outcomes can be improved through deprescribing. The principles of deprescribing include reviewing all current medications, identifying medications to be ceased, substituted or reduced, planning a deprescribing regimen in partnership with the patient and frequently reviewing and supporting the patient. Medications to be used with caution will be discussed and practical deprescribing advice offered in this review. A clear understanding of the purpose and risk of medication by the prescribing team and the patient, and a considered deprescribing plan, can improve health outcomes in older people.