International Journal of Clinical Pharmacy

, Volume 36, Issue 1, pp 26–29 | Cite as

Benefits of deprescribing on patients’ adherence to medications

  • Emily ReeveEmail author
  • Michael D. Wiese


Deprescribing is a holistic process of medication cessation that encompasses gaining a comprehensive medication list, identifying potentially inappropriate medications, deciding if the identified medication can be ceased, planning the withdrawal regimen and monitoring, support and follow-up. It is currently being investigated as a mechanism to reduce unnecessary or redundant medications. However, given the systematic and patient-centred nature of the deprescribing process, it is possible that it may also confer additional benefits such as improving adherence to medications, even if there is no net reduction in overall medication use. Specifically, deprescribing may improve adherence via reducing polypharmacy, reducing the financial costs associated with medication taking, increasing the patient’s medication knowledge through education, increasing patient engagement in medication management and resolution of adverse drug reactions. More research into deprescribing must be conducted to establish if these potential benefits can be realised, in addition to establishing any negative consequences.


Adherence Deprescribing Inappropriate medication use Medication withdrawal 



Ms Emily Reeve’s PhD candidacy (of which this review was conducted within) is funded by an Australian Postgraduate Award (APA).

Conflicts of interest



  1. 1.
    Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5:345–51.PubMedCrossRefGoogle Scholar
  2. 2.
    Woodward M. Deprescribing : achieving better health outcomes for older people through reducing medications. J Pharm Pract Res. 2003;33:323–8.Google Scholar
  3. 3.
    Le Couteur DG, Banks E, Gnjidic D, McLachlan A. Deprescribing. Australian Prescriber. 2011;34:182–5.Google Scholar
  4. 4.
    Hardy JE, Hilmer SN. Deprescribing in the last year of life. J Pharm Pract Res. 2011;41:146–51.Google Scholar
  5. 5.
    Bain KT, Holmes HM, Beers MH, Maio V, Handler SM, Pauker SG. Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process. J Am Geriatr Soc. 2008;56:1946–52.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Scott I, Gray L, Martin J, Mitchell C. Minimizing inappropriate medications in older populations: a 10-step conceptual framework. Am J Med. 2012;125:529–37.PubMedCrossRefGoogle Scholar
  7. 7.
    Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487–97.PubMedCrossRefGoogle Scholar
  8. 8.
    Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2002;26:331–42.CrossRefGoogle Scholar
  9. 9.
    Shoemaker SJ, de Oliveira DR. Understanding the meaning of medications for patients: the medication experience. Pharm World Sci. 2008;30:86–91.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. The Cochrane Library. 2008;2:CD000011.Google Scholar
  11. 11.
    Barat I, Andreasen F, Damsgaard EM. Drug therapy in the elderly: what doctors believe and patients actually do. Br J Clin Pharmacol. 2001;51:615–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Chapman RH, Benner JS, Petrilla AA, Tierce JC, Collins R, Battleman DS, et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern Med. 2005;165:1147–52.PubMedCrossRefGoogle Scholar
  13. 13.
    Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–310.PubMedCrossRefGoogle Scholar
  14. 14.
    Nichols-English G, Poirier S. Optimizing adherence to pharmaceutical care plans. J Am Pharm Assoc. 2000;40:475–85.Google Scholar
  15. 15.
    Dolovich L, Nair K, Sellors C, Lohfeld L, Lee A, Levine M. Do patients’ expectations influence their use of medications? Qualitative study. Can Fam Physician. 2008;54:384–93.PubMedCentralPubMedGoogle Scholar
  16. 16.
    Safran DG, Neuman P, Schoen C, Montgomery JE, Li W, Wilson IB, et al. Prescription drug coverage and seniors: how well are states closing the gap? Health Aff (Millwood). 2002;21:W253–68.Google Scholar
  17. 17.
    Reeve E, Wiese MD, Hendrix I, Roberts M, Shakib S. People’s attitudes, beliefs, and experiences regarding polypharmacy and willingness to deprescribe. J Am Geriatr Soc. 2013;61:1508–14.PubMedCrossRefGoogle Scholar
  18. 18.
    Williams A, Manias E, Walker R. Interventions to improve medication adherence in people with multiple chronic conditions: a systematic review. J Adv Nurs. 2008;63:132–43.PubMedCrossRefGoogle Scholar
  19. 19.
    Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555–67.PubMedCrossRefGoogle Scholar
  20. 20.
    Byrne M, Walsh J, Murphy AW. Secondary prevention of coronary heart disease: patient beliefs and health-related behaviour. J Psychosom Res. 2005;58:403–15.PubMedCrossRefGoogle Scholar
  21. 21.
    Conn VS, Hafdahl AR, Cooper PS, Ruppar TM, Mehr DR, Russell CL. Interventions to improve medication adherence among older adults: meta-analysis of adherence outcomes among randomized controlled trials. Gerontologist. 2009;49:447–62.PubMedCrossRefGoogle Scholar
  22. 22.
    Iyer S, Naganathan V, McLachlan AJ, Le Couteur DG. Medication withdrawal trials in people aged 65 years and older: a systematic review. Drugs Aging. 2008;25:1021–31.PubMedCrossRefGoogle Scholar
  23. 23.
    Hering-Hanit R, Yavetz A, Dagan Y. Effect of withdrawal of misused medication on sleep disturbances in migraine sufferers with chronic daily headache. Headache. 2000;40:809–12.PubMedCrossRefGoogle Scholar
  24. 24.
    Chiatti C, Bustacchini S, Furneri G, Mantovani L, Cristiani M, Misuraca C, et al. The economic burden of inappropriate drug prescribing, lack of adherence and compliance, adverse drug events in older people. Drug Saf. 2012;35:73–87.PubMedCrossRefGoogle Scholar
  25. 25.
    Donovan J, Blake D, Fleming W. The patient is not a blank sheet: lay beliefs and their relevance to patient education. Rheumatology. 1989;28:58–61.CrossRefGoogle Scholar
  26. 26.
    Beer C, Pk Loh, Peng YG, Potter K, Millar A. A pilot randomized controlled trial of deprescribing. Ther Adv Drug Saf. 2011;2:37–43.CrossRefGoogle Scholar
  27. 27.
    Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170:1648–54.PubMedCrossRefGoogle Scholar
  28. 28.
    Williams M, Pulliam C, Hunter R, Johnson T, Owens J, Kincaid J, et al. The short-term effect of interdisciplinary medication review on function and cost in ambulatory elderly people. J Am Geriatr Soc. 2004;52:93–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Hilmer SN, Gnjidic D, Le Couteur DG. Thinking through the medication list-Appropriate prescribing and deprescribing in robust and frail older patients. Aust Fam Physician. 2012;41:924.PubMedGoogle Scholar
  30. 30.
    Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med. 2005;143:427–38.PubMedCrossRefGoogle Scholar
  31. 31.
    Nguyen GC, LaVeist TA, Harris ML, Datta LW, Bayless TM, Brant SR. Patient trust in physician and race are predictors of adherence to medical management in inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:1233–9.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Lee YY, Lin JL. The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Soc Sci Med. 2009;68:1060–8.PubMedCrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2013

Authors and Affiliations

  1. 1.School of Pharmacy and Medical Sciences and Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia
  2. 2.Department of Clinical PharmacologyRoyal Adelaide HospitalAdelaideAustralia

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