Deprescribing and managing polypharmacy in frail older people: a patient-centred approach in the real world.

Polypharmacy is common in people with multiple long-term conditions (LTC) to relieve symptoms and improve quality of life. However, it is also associated with poor outcomes and increased risk of adverse drug events in older people. Older people are seldom involved in therapeutic research, and when the results are applied to those with multiple LTCs, it can increase pill burden and adverse events without necessarily replicating the expected positive outcomes. This article describes a pharmacist-led, patient-centred approach to deprescribing in a 73-year-old diabetic man taking multiple medication, with gastrointestinal (GI) and pain symptoms as well as poor adherence to medicines. The approach considered his perspective and experience of taking his many medicines into account while using the best available research evidence and the clinician's experience. After six visits over 8 weeks, the patient was more involved with self-managing his diabetes, his pain and GI symptoms improved and overall pill burden was reduced.