Medication changes after review
Medications most commonly deprescribed successfully and consistently in the reviewed studies included multivitamins, proton pump inhibitors, antihypertensives, and analgesics. Statins were also able to be easily deprescribed in patients with limited life expectancy.25,34 Antidementia drugs and antipsychotics were reduced after CGA29; however, another study noted that antipsychotics were often psychiatrist managed and this was a barrier to deprescribing attempts.25 Another perceived barrier to deprescribing cited by doctors was a lack of information regarding the indication of medications. This was highlighted as a significant reason why proton pump inhibitors are continued.35 (A particular concern given the possible long-term effects of proton-pump inhibitors, including an increased risk of gastric cancers).70 It was noted that the medications identified as inappropriate in these outpatient clinics are similar to those highlighted in other clinical settings.13,71
In the haemodialysis outpatient unit, targeted deprescribing of quinine, diuretics, statins, α1-blockers, and proton pump inhibitors was effective using a medication algorithm.35 In the memory clinic, medications affecting cognition were a focus and they were able to deprescribe benzodiazepines and tricyclic antidepressants.37 It was suggested that deprescription may be most successful when targeting select classes of drugs and following patient-specific drug recommendations.15