Intended for healthcare professionals

Rapid response to:


Rationalising medications through deprescribing

BMJ 2019; 364 doi: (Published 07 February 2019) Cite this as: BMJ 2019;364:l570

Rapid Response:

Re: Rationalising medications through deprescribing

Risk and fitness assessment before anaesthesia for elective surgery would seem to represent an ideal opportunity for a snapshot review of current medications. A fresh pair of medical eyes to detect drugs no longer necessary, or ones that may be causing harm. The mind behind those eyes however usually relies on intelligent guesswork about the reasons for prescriptions being started, and without knowing the full story is often reluctant to change anything except what has been an obvious oversight. An unknown hospital doctor seeming to ride roughshod over carefully thought-out care strategies and compromises, risks strengthening the walls between primary and secondary care, rather than the bridges.

We often think it better to simply mention to the patient that it would be reasonable for them to ask, when they next see their GP, whether a specific medication remains necessary or the best one for them. As prescribers we should all try to ensure that our patients clearly understand the reasons for our prescriptions, and also the circumstances under which they might be discontinued.

Competing interests: No competing interests

21 February 2019
Ashoke Shah
CT1 anaesthesia
Mark Davies, consultant in anaesthesia & perioperative medicine
Royal Liverpool & Broadgreen University Hospitals NHS Trust
Liverpool L7 8XP