Intended for healthcare professionals


Rationalising medications through deprescribing

BMJ 2019; 364 doi: (Published 07 February 2019) Cite this as: BMJ 2019;364:l570
  1. Anthony J Avery, professor of primary healthcare1,
  2. Brian G Bell, research fellow1
  1. 1Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to: A J Avery tony.avery{at}

Careful judgment is required to optimise benefit and minimise harm

With an ageing population and growth in multimorbidity and polypharmacy, increasing attention is being paid to deprescribing. This term has become widely used in recent years, and there are numerous definitions.1 Put simply, it is the process of withdrawing drugs to try to improve outcomes.2 But it is important to recognise this is a complex process; careful judgment is required to balance the potential risks and benefits of withdrawing medicines.

Since TheBMJ last published an editorial on deprescribing in 20142 at least three systematic reviews have been published345 as well as several studies not included in these reviews.678 Here we consider the latest evidence and guidance on withdrawing drug treatments.

Clearly, patients should receive only the medications that they want and need. If deprescribing is required it’s important to know the safest and most effective approach, what resources are needed to …

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