De-presciption: what, when and how?

Authors

  • HAM Nazmul Ahasan Professor of Medicine, Popular Medical College, Dhaka, Bangladesh
  • Homayra Tahseen Hossain Associate Professor of Medicine, Popular Medical College, Dhaka, Bangladesh
  • Chandra Shekhar Bala Assistant Professor of Medicine, attached to National Institute of Neuroscience & Hospital, Dhaka, Bangladesh
  • Ishrat Binte Reza Assistant Professor of Medicine, Popular Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/jbcps.v38i4.48979

Keywords:

De-prescription, Deprescribing, Polypharmacy

Abstract

De-prescription or de-prescribing is a new idea in clinical medicine. This is the structured way of withdrawing of inappropriate medication supervised by a health care professional with the goal of managing polypharmacy and improving outcomes. It is estimated that half of older adult patients are treated with polypharmacy (five or more drugs). The prevalence of Polypharmacy in the elderly is higher, ranging from 30% to 70%, even reaching 90% in residents of some residential geriatric care facilities in developed nations. Polypharmacy in the elderly increases the risk of adverse reactions, inappropriate prescriptions, drug interactions, number of hospitalizations, costs, and even death. Polypharmacy and CNS drugs increase fall risk by about 50%. Withdrawal of psychotropic drugs reduced falls by 66%. There are different deprescribing models. These are focused especially on elderly patients as well as on specific specialties such as psychiatry. It includes meticulous evaluation of the patient, identifying potentially inappropriate medications, prioritizing drug discontinuation, performing the deprescription and monitoring the result bearing in mind the risks of deprescribing.

J Bangladesh Coll Phys Surg 2020; 38(4): 185-190

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Published

2020-09-08

How to Cite

Ahasan, H. N., Hossain, H. T., Bala, C. S., & Reza, I. B. (2020). De-presciption: what, when and how?. Journal of Bangladesh College of Physicians and Surgeons, 38(4), 185–190. https://doi.org/10.3329/jbcps.v38i4.48979

Issue

Section

Review Articles