drjustincoleman

What’s old is new again. Hipster beards are so in, they’re out, and where we used to simply cease medications—we now deprescribe them.

The art of commencing medicinal herbs dates back to Neolithic times. The art of stopping them began about a week later.

Probably why Hippocrates had to remind us to do no harm.

With this history, we gen-dinosaur GPs have recently been scratching our beardy chins wondering how we missed the memo that deprescribing is now a ‘thing’.

Mind you; old or new, learning how to stop medication is critical for patient care. And hopefully, now we have a word for it, tomorrow’s deprescribers will do it smarter and harder than we ever did.

Our generation received no explicit teaching, gleaning what we could from our mentors and, no doubt, from our mistakes.

A recent article in The Conversation highlights the dubious practice of using one medicine to counter the side effects of another. This is fine if the first medicine is vital and the second makes the first tolerable. But more often the medicine cabinet rivals a lolly shop, and vague side effects are ubiquitous.

For the 10 per cent of Australians over 65 years taking 10 or more medications, an antacid or antinauseant may just reflect that the stomach is coping with nine other pills. I’d argue sometimes even the antidepressant is a product of a similar prescribing cascade. Continue reading →