How can I effectively assess the appropriateness of a patient's current medication regimen before considering deprescribing?

To effectively assess the appropriateness of a patient's current medication regimen before considering deprescribing, conduct a structured medication review that critically examines all prescribed, over-the-counter, and complementary medicines the patient is using, including their indications and alignment with national guidance. This review should involve a thorough discussion with the patient (and carers if appropriate) about the benefits and harms they are experiencing, their understanding, concerns, and preferences regarding their medicines. Evaluate the safety, efficacy, and necessity of each medicine, considering any adverse drug reactions or dependence-related issues such as early running out of medicines or requests for dose increases. Incorporate clinical factors such as changes in the patient's health status, social circumstances, and any monitoring requirements. Use a shared decision-making approach to weigh the benefits and risks of continuing, adjusting, or stopping medicines, ensuring the patient is supported and informed throughout the process. Document and update the management plan accordingly, providing the patient with a copy and clear contact information for concerns. This approach optimizes treatment impact, minimizes medication-related problems, and supports deprescribing when appropriate, especially in cases of polypharmacy or resolved conditions. Additionally, consider multidisciplinary input and ensure good communication among healthcare professionals involved in the patient's care to avoid fragmentation and ensure continuity. Recent literature supports that incorporating behaviour change techniques and patient empowerment during deprescribing interventions enhances effectiveness and patient adherence to changes in medication regimens NICE NG215,NICE NG5,NICE,NICE CG76Hansen et al. 2018Halli-Tierney et al. 2019Raju et al. 2023.