Deprescribing: helping patients safely reduce medications
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Dr. Cheryl Sadowski, a pharmacy researcher at the University of Alberta in Canada, advocates for deprescribing, the practice of regularly reviewing and carefully reducing medications that are no longer needed or are causing harm.
She notes that many older adults take ten or more medications simultaneously, increasing their risk of harmful drug interactions. This practice, called polypharmacy, often continues despite changes in how bodies process drugs with age, and symptoms are mistakenly attributed to aging instead of medication side effects.
Deprescribing involves reducing dosages, substituting medications with fewer risks, or stopping them altogether. Sadowski began working with the Canadian Medication Appropriateness and Deprescribing Network in 2015 to provide resources for healthcare professionals and patients. She identifies sleeping pills, heartburn medications (proton pump inhibitors), and pain prescriptions as medications most often overprescribed or linked to negative effects.
Sadowski recommends patients ask their healthcare providers five questions about each medication: why they are taking it, its potential benefits and harms, if it can affect memory or balance, if it can be stopped or reduced, and who to follow up with. She stresses that deprescribing should be a shared decision between patient and provider, with a slow, monitored reduction in dosage and open communication to address concerns and ensure trust.
Research suggests deprescribing succeeds in over 80% of cases when done collaboratively and intentionally.
