Deprescribing: the emerging evidence for and the practice of the 'geriatrician's salute'

Age and Ageing
Sarah N Hilmer, Danijela Gnjidic

Abstract

The process of a health professional withdrawing medicines for which the current risk may outweigh the benefit in the individual patient has been given a variety of names including the colloquial 'geriatrician's salute', 'de-intensification' and increasingly 'deprescribing'. The rise of deprescribing as a word with a definition, evidence base and implementation plan, reflects the changing environment in which we practice. In particular, the emphasis on evidence-based medicine and the need to care for our expanding ageing populations, which requires application of components of geriatric evaluation and management by a wider range of health care practitioners. However, there are still significant challenges related to research on the safety, efficacy and implementation of deprescribing. In this commentary, we discuss the current evidence on the effects of deprescribing, emergence of implementation tools to embed deprescribing into the clinical care of older adults, as well as efforts to develop guidelines to improve health care practitioners' awareness and self-efficacy of deprescribing. Ultimately, judicious prescribing and deprescribing, across a wide range of health care settings, ought to enable older people to use medicines ...Continue Reading

References

Apr 17, 2012·Clinics in Geriatric Medicine·Danijela GnjidicSarah N Hilmer
Aug 6, 2013·Drugs & Aging·Emily ReeveMichael D Wiese
Nov 14, 2013·Age and Ageing·Tischa J M van der CammenMirko Petrovic
Mar 24, 2015·JAMA Internal Medicine·Ian A ScottJennifer H Martin
Apr 15, 2016·British Journal of Clinical Pharmacology·Amy T PageChristopher D Etherton-Beer
Jun 13, 2016·Journal of the American Medical Directors Association·Wade ThompsonBarbara Farrell
May 1, 2017·European Journal of Clinical Pharmacology·Emily ReeveDanijela Gnjidic
Oct 23, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Chanel F Whittaker, Jeffrey C Fink

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Citations

Jun 5, 2019·Journal of the American Geriatrics Society·Joshua D NiznikCarolyn T Thorpe
Mar 6, 2019·European Journal of Clinical Pharmacology·Kristel PaqueTinne Dilles

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