title: Deprescribing in older people.
abstract: Older people with chronic disease have great potential to benefit from their medications but are also at high risk of harm from their medications. The use of medications is particularly important for symptom control and disease progression in older people. Under-treatment means older people can miss out on the potential benefits of useful medications, while over-treatment (polypharmacy) puts them at increased risk of harm. Deprescribing attempts to balance the potential for benefit and harm by systematically withdrawing inappropriate medications with the goal of managing polypharmacy and improving outcomes. The evidence base for deprescribing in older people is growing. Studies to reduce polypharmacy have used a range of methods. Most evidence for deprescribing relates to the withdrawal of specific medications, and evidence supports attempts to deprescribe potentially inappropriate medicines (such as long-term benzodiazepines). There is also evidence that polypharmacy can be reduced by withdrawing specific medications using individualised interventions. More work is needed to identify the sub-groups of older people who may most benefit from deprescribing and the best approaches to undertaking the deprescribing interventions.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. Electronic address: Amy.page@uwa.edu.au.
authors.forename: Amy Theresa
authors.initials: AT
authors.lastname: Page
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Potter
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Clifford
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Etherton-Beer
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000188:drug therapy*; D000069340:Deprescriptions; D064420:Drug-Related Side Effects and Adverse Reactions; D006299:Health Services for the Aged; D006801:Humans
keywords: Deprescribing; Inappropriate prescribing; Older adults; Polypharmacy