Doctors who stop people’s drugs and other stories . . .BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1399 (Published 18 March 2015) Cite this as: BMJ 2015;350:h1399
“I am a doctor who stops people’s drugs.” That’s the boast of many a geriatrician, and “deprescribing” is the word now used for this process. In an anonymised electronic survey (Age Ageing 2015, doi:10.1093/ageing/afv028), geriatricians rated limited life expectancy and cognitive impairment as important drivers of deprescribing practices. Doctors’ attitudes varied greatly, and—as the concepts of “choosing wisely,” “too much medicine,” and “minimally disruptive medicine” gain ground—the investigators call for further exploration of the factors that influence deprescribing and how it affects patient outcomes.
Better than deprescribing would be not to prescribe in the first place. People with type 2 diabetes are typically prescribed several long term drugs, and there is a strong ethical argument that they should be fully informed of the estimated individualised benefits and harms of each before starting. Several decision aids have been produced, but a qualitative study of patient responses (British Journal of General Practice 2015, doi:10.3399/bjgp15X683953) to …
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