Creating evidence-based deprescribing guidelines

Prescribers have said that it’s difficult to stop medications when prescribing guidelines only talk about starting them. The “Deprescribing Guidelines for the Elderly” project developed evidence-based deprescribing guidelines to support clinicians in safely reducing or stopping medications. We conducted a national survey to identify priorities for deprescribing guidelines. Then, we used an evidence-based approach to develop deprescribing guidelines for three specific drug classes — proton pump inhibitors, benzodiazepine receptor agonists, and antipsychotics. We piloted these guidelines in three long-term-care and three Family Health Teams in the Ottawa area in Ontario, Canada. The resulting guidelines have been published and a number of related materials are available in the guidelines and patient information sections of this website.

More about this project can be found here.
Co-leads: Dr. Barbara Farrell and Dr. James Conklin
Co-investigators: Dr. Lise BjerreDr. Lisa McCarthyDr. Kevin PottieDr. Lalitha Raman-WilmsDr. Carlos Rojas-Fernandez
Contact: deprescribing@bruyere.org

Funder (2013-2016): This research/study was supported by the Ontario Pharmacy Research Collaboration (OPEN) and funded by the Government of Ontario Health Services Research Fund.

Additional links:

Developing Deprescribing Guidelines – Video

This video helps viewers understand:

  • The rationale for evidence-based deprescribing guidelines
  • The process used for developing the deprescribing guidelines
  • The steps that a health care professional and patient need to go through to make and carry out safe deprescribing processes

Access the video on YouTube here 

Related Publications

 

  • Boghossian TA, Rashid FJ, Welch V, Thompson W., Rojas-Fernandez C., Moayyedi P, Pottie K, Pizzola L, Walsh K, Farrell B. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database of Systematic Reviews 2017;3: DOI: 10.1002/14651858.CD011969.pub2

 

 

 

 

 

 

 

 

 

  • Pottie K, Thompson, W, Davies S, Grenier J, Sadowski CA, Welch V, Holbrook A, Boyd C, Swenson R, Ma A, Farrell B. Deprescribing benzodiazepine receptor agonists: Evidence based clinical practice Guideline. Canadian Family Physician 2018; 64:339-351.

 

 

  • Bjerre LM, Farrell B, Hogel M, Graham L, Lemay G, McCarthy L, Raman-Wilms L, Rojas-Fernandez C, Sinha S, Thompson W, Welch V, Wiens A. Deprescribing antipsychotics for behavioural and psychological symptoms of dementia (BPSD) and insomnia: Evidence-based clinical practice guideline. Canadian Family Physician 2018;64(1):17-27.

 

  • Farrell B, Black C, Thompson W, McCarthy L, Rojas-Fernandez C, Lochnan H, Shamji S, Upshur R, Bouchard M, Welch V. Deprescribing antihyperglycemic agents in older persons: an evidence-based clinical practiced guideline. Canadian Family Physician 2017;63(11):832-842.

 

  • Thompson W, Black C, Welch V, Farrell B, Bjerre LM, Tugwell P. Patient values and preferences surrounding proton pump inhibitor use: a scoping review. Patient 2017 Jun 12, doi 10.1007/s40271-017-0258-4.