JPPR doubles down on deprescribing

The concept of deprescribing is front and centre in the October issue of the Journal of Pharmacy Practice and Research (JPPR) which, through a number of perspectives, supports the mitigation of sub-therapeutic or potentially harmful polypharmacy as integral to all pharmacy practice.

SHPA Chief Executive Kristin Michaels says deprescribing focus in the flagship journal of the Society of Hospital Pharmacists of Australia (SHPA) is a timely loop back to the origins of the now-common term.

‘We believe the first published use of the phrase “deprescribing” was in the pages of JPPR, so it is fitting we see new discussions and perspectives on this crucial aspect of medicines management again in SHPA’s flagship journal. 

‘Deprescribing is a concept championed by all pharmacists and one strongly backed by SHPA, evident in each of our five Choosing Widely recommendations around ceasing or limiting administration of primary preventative medicines, antibiotics, antipsychotic medicines, NSAIDs and sub-therapeutic doses of codeine, depending on particular prevailing circumstances.’

In his editorial JPPR Editor-in-Chief Dr Chris Alderman questions why ‘the deprescribing movement, however meritorious, is unfortunately still struggling to find widespread traction, a notion that is difficult to grasp in a context of evidence-based medicine.’

Cognisant of the importance that deprescribing needs to be considered at all points in the care continuum, Dr Alderman points to carefully considered financial incentives as enablers of the time and effort needed to accommodate the finer points of good prescribing and medicines optimisation: ‘Given that money seems to be partially at the heart of the problem, could it also form part of the solution?’

At a time when the care of older Australians has risen to the forefront of national consciousness, October JPPR issue also sees ten recommendations for systems-level improvements in the quality use of medications for older people.

The authors from New South Wales, Victoria and Western Australia emphasised the need for consumer-centred care and the communication of medicines information, both to consumers and between health professionals, following a National Stakeholders’ Meeting on Quality use of Medicines to Optimise Ageing in Older Australians held in 2015.

Delivering on a proposal from the 2015 meeting, the article also reveals a complex ‘systems map’, ‘to better understand the complex pathways older Australians take through healthcare systems’, to support the recommendations.

October JPPR is out now; free to SHPA members.

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