Too much medicine in older people? Deprescribing through shared decision making

Abstract

Too much medicine is an increasingly recognised problem, and one manifestation is inappropriate polypharmacy in older people. Polypharmacy is usually defined as taking more than five regular prescribed medicines. It can be appropriate (when potential benefits outweigh potential harms) but increases the risk of older people experiencing adverse drug reactions, impaired physical and cognitive function, and hospital admission.There is limited evidence to inform polypharmacy in older people, especially those with multimorbidity, cognitive impairment, or frailty. Systematic reviews of medication withdrawal trials (deprescribing) show that reducing specific classes of medicines may decrease adverse events and improve quality of life