The vast majority of doctors are aware of the importance of deprescribing (reducing or withdrawing) inappropriate medication in elderly patients, although not all clinicians use specific methodologies and criteria for this in their clinical practice.
A study signed by Anabela Pereira and Oscar Ribeiro, researchers from CINTESIS@RISE/ University of Aveiro, and Manuel Veríssimo from iCBR / Faculty of Medicine of the University of Coimbra, analyzed awareness, attitudes, training and deprescribing practices among Portuguese doctors.
The aim of this research, published in Acta Médica Portuguesa, was to inform future health strategies and policies on deprescribing, bearing in mind that Portugal is one of the oldest countries in Europe.
Deprescribing consists of withdrawing or reducing medication considered potentially inappropriate, in a way that is safe and based on evidence, as a way of reducing polymedication and thus reducing adverse events and improving health outcomes. It is particularly important for older people, who are generally the most polymedicated due to having several diseases at the same time.
According to the authors, the results highlight “a broad awareness of deprescribing among Portuguese doctors”, but reveal “gaps and inconsistencies in its application”, pointing out that deprescribing is “a relatively recent concept and only in recent years has it established itself as a safe and effective approach to optimizing medication for elderly patients”.
In the survey, 92% of doctors were deprescribing, but only around 40% used specific deprescribing methodologies and/or criteria to identify potentially inappropriate medicines.
The authors revealed that, in their study, training in deprescribing was associated with the use of deprescribing methods. “Bearing in mind that less than half of the participating doctors had training in deprescribing, this may be one of the factors that explains the gap found,” they point out.
General practitioners and internal medicine specialists were the ones who showed “greater familiarity and training in deprescribing” and reported “adopting deprescribing methodologies more frequently”, when compared to doctors practicing in hospitals.
According to Anabela Pereira, a researcher at CINTESIS@RISE, these data underline “the need to develop national policies and initiatives aimed at optimizing medication for the elderly in the National Health System”.
Likewise, the conclusions now published emphasize “the importance of addressing the current gaps and designing a strategy to implement safe deprescribing as part of healthcare for the older population.”