Sivagnanam Gurusamy
Department of Pharmacology, Indira Gandhi Medical College and Research Institute, Puducherry, India.
J Pharmacol Pharmacother. 2016 Jul-Sep;7(3):133-7. doi: 10.4103/0976-500X.189680.
Deprescribing is a structured approach to drug discontinuation. An alternative suggested term is "prescription metabolism." The major aim of deprescription is to purge the drug(s) considered unwanted in a given patient, especially in the elderly patients with multiple comorbidities or in those suffering from chronic disease. Like drug metabolism, prescription metabolism is a way of eliminating unwanted, troublesome, or cost-ineffective medications. The removal of such drugs has been found to decrease the incidence of adverse drug reactions and improves the rate of medication adherence, thereby reducing the economic burden on the patient as well as on the health care providers. Certain categories of drugs are to be tapered rather than abruptly stopped. Despite the availability of many tools to minimize drug therapy-related problems, there is little guidance for the process of deprescribing in general clinical practice. Various methods to reduce the risks of polypharmacy include patient education, physician education, and regulatory intervention. The suggested S and S approach (seek and screen, save and severe, sensitize and supervise) may be tried for deprescribing in general practice. More research on deprescribing is the need of the hour in almost all branches of clinical medicine which may pave the way for the betterment of health care.
减药是一种有组织的停药方法。另一个建议使用的术语是“处方代谢”。减药的主要目的是清除特定患者（尤其是患有多种合并症的老年患者或患有慢性病的患者）中被认为不需要的药物。与药物代谢一样，处方代谢是一种消除不需要的、麻烦的或成本效益低的药物的方式。已发现停用此类药物可降低药物不良反应的发生率，并提高用药依从率，从而减轻患者以及医疗服务提供者的经济负担。某些类别的药物应逐渐减量而非突然停药。尽管有许多工具可将药物治疗相关问题降至最低，但在一般临床实践中减药过程几乎没有指导。减少多重用药风险的各种方法包括患者教育、医生教育和监管干预。一般实践中减药可尝试建议的S和S方法（寻找与筛查、保存与精简、提高认识与监督）。几乎所有临床医学分支目前都需要对减药进行更多研究，这可能为改善医疗保健铺平道路。
