The challenge of deprescribing is to apply quality use of medicines principles using a person-centred approach where polypharmacy, co-morbidities and fragility converge with a lack of evidence or guidelines to aid decision-making.
CorrelateCorrelate the challenges of an ageing population with medication use and polypharmacy
ExplainExplain to the patient or their carer the rationale for deprescribing medicines as indicated
CriticallyCritically evaluate medicines that are at higher risk of causing older adults to experience medication-related problems
PlanPlan and initiate a withdrawal trial taking into account medicines that should be ceased slowly
Jenny, a practicing pharmacist, is a teaching associate at Monash University, Melbourne. She is a member of the PSA Branch committee, the Expert Group for Therapeutic Guidelines – Respiratory, an editorial board member of AUS-DI, SHPA "Don’t Rush to Crush", and the Guidelines Committee for the Australian Asthma Handbook (AAH). Jenny is an accredited consultant pharmacist who conducts her own company, which focuses on medication reviews in the home and aged care facilities, plus education, writing, training, and consultation. Jenny works regularly in community pharmacy plus sessions in a GP clinic at a Community Health Centre. She has published over 350 educational articles. Jenny has presented talks at many Australian and international conferences to GPs, nurse practitioners, nurses, podiatrists, pharmacists, and other health professionals. In 2013, she was awarded the Australian Pharmacist of the Year by the Pharmaceutical Society of Australia and, in 2016, the AACP-MIMs Australian Consultant Pharmacist of the Year.
- Incidence of medication use
- Polypharmacy and principles of deprescribing
- Barriers to deprescribing
- Classes of medicines for deprescribing
- Planning withdrawal
Nurse practitioners and other health professionals who prescribe medications or are heavily involved in medication management.
Confidently consider whether to continue, reduce or cease medications that are not effective or may no longer be appropriate for a particular person.
It is well known that polypharmacy has the potential to result in adverse events for patients. Therefore, the prescribing process must not only include a review, but also cessation of medicines. Cessation of medications may be a particularly appropriate action in certain clinical situations amongst older adults. Deprescribing has been described as the systematic process of identifying and discontinuing potentially inappropriate medicines with the aim of minimising polypharmacy and improving patient outcomes. A recent network analysis of the various definitions used in multiple articles across many countries proposed this definition: “Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes.” Reviewing a patient’s medication regime, and ceasing unnecessary medicines, can lead to an improved quality of life for patients.
Health professionals in Australia that are registered with AHPRA are required to obtain continuing professional development (CPD) hours/points each year that relates to their context of practice, in order to comply with mandatory regulatory requirements.