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◆ The Medical Journal of Australia2026-04-01· Deprescribing

Deprescribing in Older People: A Clinical Practice Guideline Summary

Hui Wen Quek, Xisco Reus Perello, Kenneth Lee, Atinuke Abraham, Lan Adams, Osvaldo P. Almeida, Hend Almutairi, Bree Armstrong, Leanne Boase, Juanita Breen, Lauren Brown, Gillian E. Caughey, Lewis Chan, Roger Chen, Edward Chew, Antony Clark, Tracy Ann Comans, Deirdre Criddle, Pēteris Dārziņš, Paresh Dawda, Jenny Doust, Sue Edwards, Jennifer A Gowan, Kerryn M Hart, Deborah Hawthorne, Andrew Heredia, Anne‐Marie Hill, Jesse M. Jansen, Lisa Kalisch Ellett, Helen Keen, Erin A. Kelty, Ngaire M. Kerse, Estie Kruger, Susan Kurrle, Howard Lance, Adam Livori, Rebecca Livori, Dina LoGiudice, Arduino A. Mangoni, Anthony Marinucci, Nilufeur McKay, Allison M. Mckendrick, Andrew J. McLachlan, Treasure McGuire, Stewart Mearns, Mark Morgan, Saba Nabi, Vasi Naganathan, Elaine Newman, Christopher A. C. M. Ng, Maz Osborne, Ray Parkin, Kevan R. Polkinghorne, Constance Dimity Pond, Kathleen N. Potter, Debbie Rigby, Debra Rowett, Amina Schipp, Veronika Seda, Jessica Seeto, Sepehr Shakib, Angela Shiu, Andrew Stafford, Irene J. Tan, Marc Tennant, Leanne Teoh, Stephen B. Tucker, John D. G. Watson, Donna Wellins, Tim Whitmore, Christopher Etherton‐Beer, Amy T. Page

原始摘要(英文原文)· Original abstract
INTRODUCTION: Older people face higher risks of medicine-related harm due to polypharmacy and the use of potentially inappropriate medicines. Current treatment guidelines rarely specify when to stop medicines, leading to medicines often being continued indefinitely without a clear deprescribing plan. While deprescribing guidelines exist for some medicine classes, limited guidance is a major barrier to deprescribing. These new guidelines address this gap by providing structured recommendations that complement more detailed drug-specific deprescribing guidance, disease-specific therapeutic guidelines and non-pharmacological management resources. These guidelines were developed by a team of 72 experts, including consumer representatives, and were further shaped by feedback from public consultation and independent reviewers. MAIN RECOMMENDATIONS: The guidelines are intended for all healthcare professionals involved in prescribing, dispensing or administering medicines to older people. The guidelines specifically address polypharmacy and medicines commonly dispensed for regular use in people aged ≥ 65 years, as well as other medicines where there is evidence to consider deprescribing in this cohort. The guidelines provide 185 consensus-based recommendations and 70 good practice statements, covering both specific medicine categories and general deprescribing principles. The guidelines are structured into four areas: (1) when to deprescribe; (2) ongoing treatment needs; (3) how to deprescribe; and (4) monitoring requirements. CHANGES IN CARE AS A RESULT OF THE GUIDELINE: This guideline emphasises deprescribing as an integral part of the prescribing continuum. Applying a deprescribing approach encourages prescribers to consider the ongoing need for a medicine each time a prescription is re-issued, to balance benefits and harms as they evolve over time, and to ensure treatment decisions reflect an individual's goals through shared decision-making. The guideline was developed based on currently available evidence for deprescribing and expert multidisciplinary and consumer input. It supports health professionals in reviewing regular medicines, minimising harm and planning ongoing treatment or monitoring. The detailed guideline is available at https://deprescribing.com.
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