Discontinuing drug treatments

Deprescribing is the process of withdrawing drugs in an attempt to improve patient outcomes. Emerging evidence from studies of patients with multimorbidity and older people, who are a large and growing proportion of the population, shows that deprescribing may be linked to improvements in survival and quality of life.1 2 While it is sometimes asserted that patients are unwilling to have their drugs withdrawn, in a recent survey over 90% of patients reported that they would be willing to stop taking one or more of their medicines.3 Deprescribing should be considered during every regular review of a patient.

The principles of prescribing and deprescribing are highly comparable,4 although with obvious differences. Prescribing new drugs involves diagnosing a problem and establishing an indication; deprescribing involves establishing which drug may be causing a problem (an adverse drug event) or which drug does not have a current indication. Prescribing involves applying specific disease based guidelines to a patient; deprescribing involves optimising all treatments to achieve individual care goals. While prescribing for people with multimorbidity is commonly driven by guidelines that are based on single diseases, the …