Deprescribing in Older People: A Clinical Practice Guideline Summary

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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Journal
The Medical Journal of Australia
Published
2026-04-01
DOI
https://doi.org/10.5694/mja2.70174
Primary Topic
Pharmaceutical Practices and Patient Outcomes
Type
article
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0.00

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article

Deprescribing in Older People: A Clinical Practice Guideline Summary

Antony Clark, Deborah Hawthorne, Paresh Dawda, Pēteris Dārziņš et al.
The Medical Journal of Australia
Pharmaceutical Practices and Patient Outcomes
article

Deprescribing in Older People: A Clinical Practice Guideline Summary

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

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.

The Medical Journal of AustraliaVol. 224(4)
Royal Australian College of General Practitioners (AU), Lions Eye Institute (AU), Bond University (AU), Edith Cowan University (AU), The University of Sydney (AU), University of Tasmania (AU), Mater Health Services (AU), The Royal Melbourne Hospital (AU), Baker Heart and Diabetes Institute (AU), Deakin University (AU), University of Auckland (NZ), Queensland University of Technology (AU), The University of Queensland (AU), The University of Melbourne (AU), Flinders University (AU), University of South Australia (AU), Golder Associates (Canada) (CA), The University of Western Australia (AU), University of Canberra (AU), Northern Health (AU), University of Wollongong (AU), Curtin University (AU), Australian Dental Association (AU), Royal Perth Hospital (AU), Concord Repatriation General Hospital (AU), Fiona Stanley Hospital (AU), Government of Western Australia Department of Health (AU), Hornsby Ku-ring-gai Hospital (AU), Sir Charles Gairdner Hospital (AU), Queensland Rail (AU), Blacktown & Mount Druitt Hospital (AU), Environment Canterbury (NZ), Repatriation General Hospital (AU), Westmead Hospital (AU), UNSW Sydney (AU), Maastricht University (NL), National Ageing Research Institute (AU), St Vincent's Hospital Sydney (AU), Australian and New Zealand Society of Palliative Medicine (AU), Australian Diabetes Society (AU), Department of the Premier and Cabinet (AU), Australia and New Zealand Dialysis and Transplant Registry (AU), Australian Coal Research (Australia) (AU), Eastern Health (AU), Women's and Children's Health Network (AU), Ballarat Health Services (AU), Australian Pork (Australia) (AU), Victorian Aboriginal Health Service (AU), Department of Health (TW), AET (United States) (US), SA Health (AU), Monash Health (AU), Tasmanian Abalone Council (Australia) (AU), Australian Physiotherapy Association (AU), North Metropolitan Health Service (AU), South Australian Health and Medical Research Institute (AU), Royal Darwin Hospital (AU), Australian e-Health Research Centre (AU), Wagga Wagga Base Hospital (AU), IRT Group (Australia) (AU), Arts OutWest (AU), Austin Health (AU), Grampians Health, Monash University (AU), The University of Adelaide (AU), Neuroscience Research Australia (AU), The University of Notre Dame Australia (AU)
Royal Australian College of General Practitioners
Peace, Justice and strong institutions
Openalex Percentile: Top 35%
Pharmaceutical Practices and Patient Outcomes
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