Deprescribing

Question 1

What tools are available to aide deprescribing

Answer 1

STOPP START
IMPACT
NO TEARS
DROP List

Question 2

What are Woodwards (2003) 5 steps to deprescribing

Answer 2

1. Comprehensive Medical History
2. Identify inappropriate meds.
3. Determine if meds can be ceased.
4. Plan and initiate withdrawal
5. Monitor, support and document

Question 3

What attributes are required for Deprescribing

Answer 3

Acquiring a good Patient history,

pharmacology and a knowledge of disease processes,

Good clinical judgement to decide the best course of action

Question 4

When is advantageous to deprescribe

Answer 4

When Medications are causing harm
Patients are actively choosing to be non compliant
Meds are impacting on quality of life
Meds are unnecessary

Question 5

Barriers to Deprescribing

Answer 5

Patient related: perceived need or benefit.

Prescribing related: Easy intervention, learned behaviour

lack of knowledge

System related: Lack of time/ follow up opportunity, incentive related prescribing

Question 6

What are 4 key points to consider before deprescribing

Answer 6

1. Does the patient agree/ understand
2. Are there any test to carry out either before during or after deprescribing
3. Does the patient need counselling/ education around symptoms post cessation of the medication (E.g. withdrawal)
4. Is follow up required

Question 7

What is the goal of deprescribing

Answer 7

To reduce medication burden and harm. To maintain or improve quality of life

Question 8

What is a definition of deprescribing

Answer 8

It is a partnership between the patient and prescriber, where a trial discontinuation of inappropriate medication commences. In which medication can be stopped changed or reduced to meet the patients needs