Deprescribing: An Application to Medication Management in Older Adults.

Polypharmacy has been found to have potentially negative consequences for patients due to use of potentially inappropriate medications, as well as increased risk of drug interactions and adverse effects. Deprescribing has been proposed as a method of improving medication use throughout a patient's course of care. This article reviews the process of deprescribing and applies the process to medication classes commonly encountered by clinical pharmacists. This review of therapeutics included studies identified through a PubMed search and by review of the reference list of included studies. Relevant studies known to the author were also included. Previous studies have identified several classes of medications as a high priority for construction of evidence-based deprescribing guidelines. In the absence of currently available evidence-based clinical practice guidelines, this articles reviews applicable evidence and applies the deprescribing process to three high-priority medication classes: statins, cholinesterase inhibitors and bisphosphonates. Available evidence can be used to apply the deprescribing process to preventive medications for chronic diseases commonly encountered by clinical pharmacists.