Want to take less medication? Deprescribing might work

Millions of people are taking more than one type of medication per day.

Australian researchers have developed a system to help doctors identify patients who want to ‘deprescribe’ from medication to reduce the amount of daily pill popping.

With millions of people around the world taking more medication than ever, the idea of deprescribing has become a hot topic in medical circles of late.

Studies have indicated that, in some cases, doctors are too quick to prescribe some medications, which can lead to patients taking multiple medications every day. A 2012 study showed that over-50 patients are leading the way with 87.1 per cent of participants taking one or more medicines and 43.3 per cent taking five or more.

In an effort to help willing patients safely wind back on their medication, researchers from the University of Sydney’s School of Public Health developed a system to make it easier to characterise older people who take multiple medicines and those who want to deprescribe. 

Their research was published in the Journal of Gerontology on Monday.

Lead researcher from the University of Sydney’s School of Public Health, Kristie Weir, said it was an important step towards getting patients and doctors to discuss the issue together.

“Polypharmacy (multiple medications) in the older population is increasing and can be harmful,” she said. “It can be safe to reduce or carefully cease medicines (deprescribing), but a collaborative approach between patient and doctor is required.”

“Deprescribing isn’t new, but there has been a recent explosion of research in this area showing how it can be done safely and in collaboration with patients. We provide a novel approach to describe these differences between older people who are happy to take multiple medicines, and those who are open to deprescribing.

The team divided patients into three categories: those who don’t want to deprescribe; those who want to take less medication and who want an active role in the decision making with their doctor; and those who wanted their doctor to make the decision for them.

“This research shows that doctors should tailor communication to individual older people who are taking multiple medicines in order to provide the best level of care,” Weir said.

“For some patients it might be that you need to help them think a bit more about their medicines and educate them more. Whereas for others, who were already aware of what medicines they were taking, identifying preferences and goals would be appropriate.

The team concluded that there needs to be more support for patients and doctors who want to look at safely winding back medication levels.