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 Bjerre, Dr. Lisa McCarthy, Dr. Kevin Pottie, Dr. Lalitha Raman-Wilms, Dr. Carlos Rojas-Fernandez
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.
- PPI deprescribing guideline
- PPI deprescribing algorithm
- PPI deprescribing pamphlet
- PPI deprescribing patient decision-aid
- BZRA deprescribing guideline
- BZRA deprescribing algorithm
- BZRA deprescribing pamphlet
- AP deprescribing guideline
- AP deprescribing algorithm
- Deprescribing guidelines methods publication
- Deprescribing self-efficacy survey
- Developing an Evidence-based Deprescribing Guideline: Instruction Manual
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
- Farrell B, Pottie K, Thompson W, Boghossian T, Pizzola L, Rashid FJ, Rojas-Fernandez C, Walsh K, Welch V, Moayyedi P. Deprescribing proton-pump inhibitors: an evidence based clinical practice guideline. Canadian Family Physician 2017;63:354-364.
- 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
- Farrell B, Richardson L, Raman-Wilms L, de Launay D, Alsabbagh MW, Conklin J. Self-efficacy for deprescribing: A survey for health care professionals using evidence-based deprescribing guidelines. Res Social Adm Pharm, 2017; Jan 28; pii: S1551-7411(17)30055-4. doi: 10.1016/j.sapharm.2017.01.033
- Thompson W, Farrell B, Welch V, Tugwell P, Bjerre LM. Should I continue taking my acid reflux medication? Design of a pilot before/after study evaluating a patient decision aid. Can Pharm J, 2017; Jan-Feb; 150(1): 19-23.
- Thompson W, Quay TA, Rojas-Fernandez C, Farrell B, Bjerre LM. Atypical antipsychotics for insomnia: A systematic review and meta-analysis protocol. Sleep Med, 2016; Jun; 22: 13-7.
- Farrell B, Pottie K, Rojas-Fernandez CH, Bjerre LM, Thompson W, Welch V. Methodology for developing deprescribing guidelines: Using evidence and GRADE to guide recommendations for deprescribing. PLoS One, 2016; 11(8): e0161248. doi:10.1371/journal.pone.016124.
- Thompson W, Hogel M, Li Y, Thavorn K, O’Donnell D, McCarthy L, Dolovich L Black C, Farrell B. Effect of a proton pump inhibitor deprescribing guideline on drug usage and costs in long-term care. JAMDA, 2016; 17(7), 673.e1 – 673.e4.
- Conklin J, Farrell B, Ward N, McCarthy L, Irving H, Raman-Wilms L. Developmental evaluation as a strategy to enhance the uptake and use of deprescribing guidelines: protocol for a multiple case study. Implement Sci, 2015; Jun 18;10(1):91. doi: 10.1186/s13012-015-0279-0.
- Farrell B, Tsang C, Raman-Wilms L, Irving H, Conklin J, Pottie K. What are priorities for deprescribing for elderly patients? Capturing the voice of practitioners: A modified Delphi process. PLOS One, 2015; 10(4): e0122246.
- Boghossian TA, Rashid FJ, Welch V, Rojas-Fernandez C, Moayyedi P, Pottie K, Walsh K, Pizzola L, Thompson W, Farrell B. Deprescribing versus continuation of chronic proton pump inhibitor use in adults (protocol). Cochrane Database Syst Rev, 2015; Issue 11, article number CD011969.
- 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.
- Reeve E, Farrell B, Thompson W, Herrmann N, Sketris I, Magin P, Chenoweth L, Gorman M, Quirke L, Bethune G, Forbes F, Hilmer S. Evidence-based Clinical Practice Guideline for Deprescribing Cholinesterase Inhibitors and Memantine. Sydney: University of Sydney. 2018. Available at: http://sydney.edu.au/medicine/cdpc/resources/deprescribing-guidelines.php
- 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.