BMJ2016
This article draws together evidence from the psychology, communication, and decision making literature how to withdraw from polypharmacy.?
Overview
Too much medicine - inappropriate polypharmacy - is an increasingly recognised problem, particularly in older people.? Systematic reviews of medication withdrawal trials (deprescribing) show that reducing specific classes of medicines may decrease adverse events and improve quality of life.?
However, deprescribing cannot and should not be carried out by a single clinician. It should involve a shared decision making process that involves the patient, their companions and clinicians.?
This article draws together evidence from the psychology, communication, and decision making literature for each step of the shared decision making process. It describes the unique tasks required for deprescribing decisions; identifies challenges for older adults, their companions, and clinicians; and gives practical advice on how challenges may be overcome