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The benefits and harms of deprescribing

As people age there tends to be an increase in their number of comorbidities and, consequently, an increase in the number of medications they take. With Australia’s ageing population, concerns regarding polypharmacy, such as increased risk of adverse drug reactions (ADRs) and financial costs, are set to rise.1 While polypharmacy is appropriate in many individuals, up to 60% of older people are exposed to inappropriate medication use (IMU; ie, use of a medication when the harms outweigh the benefits in an individual). Medications that may initially have been appropriately prescribed can, with ageing and new medical conditions, become inappropriate.2 Evidence to date indicates that ceasing use of medication is at least as complicated as initiating treatment, and the term “deprescribing” was coined to describe the complex process that is required.1 Deprescribing has the potential to greatly improve health outcomes through stopping or reducing the dose of inappropriate medications; but, currently, concrete evidence regarding its effect is equivocal. In addition, deprescribing is not free from harm, and the potential adverse consequences of medication withdrawal must therefore be considered.

Potential benefits of deprescribing

Reduction in harms associated with polypharmacy

Being prescribed an increasing number of medications…