Patients taking multiple medicines (polypharmacy) is an ongoing challenge across the whole NHS. When patients are prescribed medicines which are no longer appropriate, this contributes to poorer health outcomes. However, it can be difficult to identify which medicines are (or are not) appropriate. Maybe we could start by asking ourselves and our patients:
Are the medicines working?
What does ‘working’ mean?
Working can mean different things depending on your perspective. For healthcare professionals, it might be about whether the anticipated health benefits of medicines are achieved. For the patient it might be about whether their medicines administration fits their routine, or if they’re getting side effects.
It is difficult to determine if medicines are working or not without an open conversation. The resources on this website are designed to support those conversations and help identify medicines which do not seem to be working for the patient.
Getting started with deprescribing
Why is deprescribing important?
Continuing to prescribe medicines which are no longer needed, wanted, or appropriate, increases risk to patients and creates waste. Reducing medication burden will improve health outcomes for patients and save time across the health system.
Which healthcare professionals should deprescribe?
Any healthcare professional who makes a decision about starting or continuing a medicine. This isn’t just about prescribers. Our toolkit is initially aimed at those working in primary care, however others may find these helpful. Our tools have been divided into some suggestions for General Practitioners, Clinical Pharmacists, and Practice Nurses. We’ve also included some information for Practice Managers for planning deprescribing in General Practices.
I don’t have time to deprescribe
As busy healthcare professionals, we understand time pressure, competing priorities and emergencies often take precedence. The tools included on this website are designed to integrate into your normal work. Asking one extra question could make all the difference. It’s also not just about one person, this is about changing systems and processes. We all need to work together to make sure that we’re reducing the number of unnecessary medicines prescribed.
I don’t know how to deprescribe
We recognise that healthcare professionals spend most of their time and effort starting rather than stopping medicines, and guidance on how to deprescribe has been lacking. In Sunderland, we are working to create more deprescribing guidance to help. You will find this guidance on the Medicines Optimisation pages here. You don’t have to know how to deprescribe everything straight away, try starting with one drug or drug class and build up from there.
How will this toolkit help?
We have a General Practice page where you can select the role which best suits you for some initial guidance. You can find an introduction to the overall toolkit and how it was developed in Sunderland on our Case Studies pages.
Or, you can just download the full deprescribing toolkit and see what you might find helpful in your own practice.
