Deprescribing: a Preventative Decalogue

Ten principles for using medicines | @NPSmedicinewise http://t.co/XpvoClaz4M
— Lluís Triquell (@TriquellBio) September 2, 2013

Lluís Triquell is a hospital pharmacist, doctor and PDG IESE. As a managing partner of Antares Consulting, he has focused his field of expertise towards the bio-industry and pharmacy, areas where he is particularly active, both in his professional life and on Twitter.

Lluís Triquell’s tweet brings us to a Decalogue published in the online magazine NPS Medicinewise, an Australian organization specializing in searching for evidence in the field of medicine and in diagnostic tests. In this Decalogue, NPS offers a number of tips that should be taken into account when prescribing drugs to the elderly. It is, therefore, to prevent de- prescribing with 10 simple criteria.

Thank you, Lluís, for giving us this opportune link.


Jordi Varela
Editor

Deprescribing in older people

Cristina Roure, Pharmacist and Vice President of Acadèmia de Ciències Mèdiques i de la Salut de Catalunya i de Baleares will explain a "deprescribing" project in her own hospital (Hospital de Terrassa). She also filled my desk with references that do no more than highlight the interest in combating, from the professional, clinical and pharmaceutical perspective, the polymedication of frail and elderly people. From all the references that I consulted, I have chosen a New Zealand-Australian source that I will summarize next. 

In New Zealand it has been estimated that 30% of people over 74 take five or more drugs, and about 10% take 10 or more. The drugs, says the reviewed publication, are often prescribed by different specialists, each of whom has followed a specific clinical practice guide for a condition or illness. Let's exemplify with a 70 year old woman suffering three chronic diseases and a couple of risk factors. This woman could easily be taking 19 daily doses of 12 different drugs at 5 different times of day, with a chance of generating 10 or more interactions.