Deprescribing Drugs - When More Is Less

Wikipedia defines deprescribing as “the process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects”. In a January 30, 2017 Washington Post article entitled, “Prescribing drugs is good. So is deprescribing”, local physician Ranit Mishori discusses what doctors are taught about prescribing drugs and that they are not taught a lot about deprescribing.

Mishori writes, “Starting in the second year of medical school (course name: pharmacology) and continuing through residency training and beyond, doctors are taught how to prescribe drugs. Here’s some of what we learn: which drugs are best for different conditions (for high blood pressure, diabetes, depression, pain and so on); which antibiotic is best for which type of infection; what are the most beneficial dosages and how frequently should certain drugs be taken; what is the best route for certain drugs (oral, rectal, IV); what the common side effects of most drugs are; which drugs are better for children, which for adults. There is much to know, and doctors have to stay up-to-date constantly, on old and new medications, recalls, generics, brand names, warning labels.”

“Drugs have an important place. But rarely do we teach young doctors – that is one of the things I do now – how and when to deprescribe a drug. Doing so is not as simple as saying “stop”. Deprescribing is its own process, requiring extreme caution and a certain skill on the part of the physician. It is a skill, however, that is not being taught, and it is barely studied to develop best practices.” 

Mishori is a professor of family medicine and the director of the Health and Media Fellowship in the Department of Family Medicine at Georgetown University School of Medicine. To read the entire article, click here: