Deprescribing: how many medicines is too many?
In an article published today in Australian Prescriber, pharmacist Michelle Liacos from Alfred Health in Melbourne, and her co-authors, look at stopping medicines when they are no longer needed to reduce the risk of medicine-related harm. This is known as deprescribing.
Medicines can play an important role in helping people stay well, especially for older people, many of whom live with several chronic illnesses. But it’s important to have your medicines reviewed by a health professional from time to time to check they’re still working for you.
Since 2006, the number of older Australians taking more than five different medicines has increased more than 50% to nearly one million.
“The more medicines you take, the higher the risk of medicine-related harm, such as hospital admissions and falls,” says Michelle Liacos.
“Studies have shown that, in some cases, reducing or stopping certain medicines may not worsen the disease they are treating, and may even reduce the risk of medicine-related harm,” says Michelle Liacos.
“Every medicine can have unwanted side effects and it is not uncommon for these to be misinterpreted as a new disease. An example might be when someone is prescribed a particular medicine for Alzheimer's disease then experiences bed-wetting as a side effect. The person may then be prescribed another medicine to manage the incontinence. But that medicine might also have side effects. This is called a prescribing cascade.
“These are all reasons why it is important to regularly check in with your health professional about whether you still need all the medicines you are currently taking.
“Reducing medicines should always be a joint decision between you and your doctor and done in a slow and careful way. If you have problems after you reduce or stop your medicine, the medicine can always be restarted if needed.
“Importantly, never stop taking a medicine without talking to your doctor or pharmacist, as stopping a medicine suddenly can be dangerous,” she says.
Read the full Australian Prescriber article.
Choosing Wisely Australia is part of a global campaign encouraging clinicians, consumers and healthcare stakeholders to have conversations about tests, treatments and procedures where evidence shows they provide no benefit or in some cases cause harm.
Deprescribing (stopping medicines that are no longer needed) is the focus of a number of Choosing Wisely recommendations from Australian peak health bodies.
5 August 2020.