Tapering patients off medication can be a tricky process for prescribers. A new clinical resource and work on new clinical guidelines aims to make navigating this process easier for GPs.
Researchers from UWA are developing clinical practice guidelines for deprescribing medications to people aged 65 years and older.
Deprescribing is the process of reducing or stopping medicines when they may no longer be necessary or when the potential risks of continuing the medication outweigh the potential benefits.
The guidelines aim to empower prescribers – like GPs – as they navigate the complex process of deprescribing.
They will serve as a resource to assist clinical decision-making in partnership with individuals, their families and carers
A team from UWA’s Medical School, including PhD candidate Amanda Quek, is collaborating on the guidelines with healthcare professionals, consumers and carers.
“If you’ve been taking multiple medications for a long time, you may not be aware of deprescribing,” Ms Quek said.
“As we age, some medications may start doing more harm than good – and sometimes, less can be better.
“Deprescribing requires a comprehensive understanding of the individual’s life stage, medical history, current health, prognosis, the nature of the condition and the characteristics of the available medicines.”
RELATED: Considerations in antidepressant deprescribing
RACGP Vice President and WA Chair Dr Ramya Raman said the deprescribing guidelines would provide welcome evidence-based recommendations for both GPs and non-GP specialists to support clinical decision making.
“Our older patients can end up with a complex regimen of medications, this reflects both the multimorbidity many of our older patients experience, and that they often see a broad team of specialists for their conditions,” she said.
“But there are risks to polypharmacy, especially among older patients and deprescribing can minimise the risks associated with polypharmacy and adverse drug events.”
Dr Raman said practitioners also may not be familiar with the often-specialised medications that other prescribers have initiated.
“This draft guideline is detailed and will be helpful as a reference alongside consultation with other members of the patient’s multidisciplinary care team,” she said.
New antidepressant deprescribing resource
A new resource accepted by the RACGP aims to provide a step-by-step guide for GPs when deprescribing antidepressants.
The RELEASE (Redressing Long-term Antidepressant Use) resources are a suite of drug specific, step-by-step tapering plans to assist GPs in helping patients to decrease or stop the use of anti-depressants.
It contains plans for 15 drugs including sertraline, escitalopram, fluvoxamine, citalopram and vortioxetine.
RELATED: Ketamine-type antidepressant added to PBS – first new listing in 30 years
The tapering plans are based on and designed for use with the recently approved Maudsley Deprescribing guidelines. They contain ‘slower’, ‘even slower’ and ‘faster’ versions.
Around one in seven Australian’s take antidepressants – around 3.5 million people. Most of these – 92% – are prescribed by GPs.
Have your say
The UWA team is inviting public comment on the draft recommendations to help develop the final clinical practice guidelines for deprescribing medications to people aged 65 years and older.
Public consultation is open until 31 May, you can share your thoughts here.
Want more news, clinicals, features and guest columns delivered straight to you? Subscribe for free to WA’s only independent magazine for medical practitioners.
Want to submit an article? Email editor@mforum.com.au