Deprescibing: Lesser Medicines For Better Health

Abstract

The proportion of older adults exposed to polypharmacy defined as use of multiple medications, is rapidly increasing in the last two decades. There are many negative medical consequences associated with polypharmacy apart from higher health care costs. Studies in developed world have revealed that people aged between 65 and 69 years fill an average of 14 prescriptions per year whereas people between 80 and 84 years of age fill an average of 18 prescriptions per year. Deprescribing is the planned and supervised process of dose reduction or stopping of medication(s) that may be causing harm, or are no longer providing benefit. The reduced homeostatic ability as people age, given the changes in pharmacokinetics, pharmacodynamics and physiological reserve, affects different regulatory systems in elderly subjects. Ideally speaking, deprescribing is an inherent component of good prescribing practice and good medicine management for improving the quality use of medicines by reducing polypharmacy, lessening the burden of medicines, correcting overuse of medicines and reducing inappropriate prescribing. JMS 2017;20(2):57-61