Deprescriben

Deprescriben is a term used in some Dutch-language medical literature to denote the act of deprescribing, or deliberately reducing or stopping medications that may no longer be beneficial or may cause harm. The concept aligns with deprescribing, a patient-centered process focused on optimizing pharmacotherapy, minimizing polypharmacy, and improving safety and quality of life.

Rationale and scope: Deprescriben is applied especially in older adults with multimorbidity, chronic illnesses, or adverse drug events, but may occur in any patient whose treatment goals have changed. The goal is to balance symptom control with risks from medications, such as drug interactions, falls, cognitive effects, and pill burden.

Process: Deprescribing involves a structured approach: comprehensive medication review, evaluation of ongoing benefits and harms, shared decision making with patients and carers, planning tapering or discontinuation when appropriate, and close monitoring for withdrawal effects or symptom recurrence. Clinicians may use tools like Beers criteria or STOPP/START to identify candidate medicines, and tailor tapering schedules to the drug class and patient.

Outcomes and challenges: When properly implemented, deprescribing can reduce polypharmacy, adverse drug events, and healthcare utilization, while maintaining or improving symptoms and function. Barriers include clinician time constraints, patient and caregiver concerns, limited guidelines for certain drugs, and fragmented care. Ongoing research aims to optimize strategies and decision support for deprescriben.