Patient selection: polypharmacy, often with multiple providers. In theory the practice could include a patient taking only 1 drug.
Tasks:
(1) Review of all medications being taken.
(2) Discontinue any drug which is no longer indicated or which does not help the patient to achieve a goal.
(3) Review a drug that does not show clear efficacy or that is causing a problem.
A clinician engaged in deprescribing may also “represcribe”:
(1) to change a formulation to reduce drug dosing or to reduce complexity in administration..
(2) to change medications to reduce interactions or adverse effects
Intended benefits of deprescribing:
(1) reduce adverse drug interactions
(2) reduce adverse drug effects
(3) improve adherence by reducing complexity of medications
(4) reduce costs
Unintended consequences:
(1) clinical deterioration or relapse
(2) withdrawal
Requirements:
(1) The clinician knows all of the drugs that the patient is taking.
(2) The clinician knows why all of the drugs are being taken.
(3) The clinicians knows what the implications of any changes will be.
(4) The clinician is in contact with all of the patient’s providers.
(5) The clinician is in contact with the patient and family to get feedback.
