Practical approaches to deprescribing in general practice

Background:
Polypharmacy is common in older people and is associated with a higher risk of adverse drug events, hospitalisation and diminished quality of life. Deprescribing, defined as the planned and supervised reduction or discontinuation of medicines, is an important strategy to address inappropriate polypharmacy. Despite its benefits, integrating deprescribing into routine general practice remains a challenge.

Objective:
This article outlines strategies for embedding deprescribing into routine general practitioner (GP) workflows, drawing on deprescribing guidelines, conversation frameworks, patient typologies and multidisciplinary collaborations.

Discussion:
GPs, with their holistic understanding of patients, are well-positioned to lead deprescribing. Key opportunities to initiate deprescribing include recent clinical events, structured health assessments and prescribing alerts. Tailored strategies are useful to frame deprescribing discussions according to patient typologies. Integrating deprescribing guidelines into practice, routinely considering deprescribing at the time of prescription renewal and auditing prescribing can help achieve sustainable improvements in clinical care.