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Chapter 22 - Deprescribing

from Section 4 - Clinical Skills in Lifestyle Medicine

Published online by Cambridge University Press:  01 May 2025

By
Daniel Okeowo ,
Beth Fylan  and
Anthony Avery
Edited by
Richard Pinder ,
Christopher-James Harvey  and
Ellen Fallows
Richard Pinder
Affiliation:
Imperial College of Science, Technology and Medicine, London
Christopher-James Harvey
Affiliation:
Imperial College of Science, Technology and Medicine, London
Ellen Fallows
Affiliation:
British Society of Lifestyle Medicine
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Summary

Deprescribing is the practice of stopping or reducing the dose of medicines that may be causing more harm than benefit to patients. Deprescribing can help prevent overprescribing, which can lead to adverse effects, unnecessary costs, or lack of efficacy. By deprescribing, patients can avoid medication-related problems, simplify their medication regimen, and enhance their wellbeing with non-pharmacological interventions. However, deprescribing is not without risks. Patients may experience withdrawal symptoms or recurrence of their original condition, which require careful monitoring and support. Deprescribing also faces several barriers, such as limited time and resources for clinicians, lack of clear guidelines, and patient reluctance or attachment to their medicines. To overcome these challenges, deprescribing should be based on a strong clinician–patient relationship, a gradual and individualised process, a multidisciplinary team approach, and a shared decision making model. Deprescribing can also be guided by various frameworks that help clinicians review, assess, prioritise, and follow-up on patients’ medications. There are tools that help identify potentially inappropriate or unnecessary medications and provide recommendations for deprescribing.

Keywords

DeprescribingLifestyle MedicinePolypharmacyMedicines regimenAdverse drug events (ADEs)Non-pharmacological therapiesQuality of lifeMedication deprescribingHealthcare systemPatient safety
Type
Chapter
Information
Essential Lifestyle Medicine , pp. 242 - 248
Publisher: Cambridge University Press
Print publication year: 2025

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References

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