Deprescribing in practice

Annette Kurrle, MD, is a geriatric coordinator at Community Hospital Mittelrhein in Germany, scientific associate at the University of Mainz, and member of the European Federation of Internal Medicine Multimorbidity Working Group.

Patients receive prescriptions from numerous clinicians over the years and eventually end up on several drugs, with the original rationale being frequently forgotten. How to practically achieve deprescribing?

Annette Kurrle, MD: We have changing diseases, we have increasing vulnerability, and each consultation, each visit, each contact with a doctor, each stay in the hospital should make polypharmacy and the indication, the dose, the interaction of the actual medication a topic [of discussion]. Often people come to the hospital with polypharmacy therapy, and they go with polypharmacy therapy. And that is not correct. We have assessments and we need a fixed place for discussions about polypharmacy in these assessments.