Consumer Preface

Deprescribing is a person-centred process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required. The process is undertaken as a partnership between the consumer and their healthcare provider.

This deprescribing guideline was developed in response to the growing need to provide guidance for optimising medication regimens in older people to reduce adverse outcomes and their treatment burden. It represents a collaborative partnership between consumers, carers, healthcare professionals, and researchers.

This guideline is not a strict mandate; rather, it serves as a resource to assist clinical decision-making in partnership with individuals, their families, and carers. We believe that open dialogue and transparent decision-making between healthcare professionals and individuals is essential. Healthcare professionals must place individuals at the centre of their care, adopting a holistic, whole-person perspective that honours each individual's unique journey. Many clinicians know their patient well, and clinical intuition, which is honed through training, experience, and deep personal understanding, can play a valuable role in guiding thoughtful, person-centred decisions.

The decision to deprescribe a medicine or a few medications is multifaceted, shaped by an interplay of clinical, psychological, sociodemographic, financial, and physiological factors, each of which may hold varying significance for different individuals. Emotional considerations in particular play a vital role for older people as they make treatment choices. Thoughtful attention to how culture, values, and preferences influence clinical contexts can ensure that older people feel valued, respected, and dignified, ultimately enhancing their healthcare experience.

At its core, deprescribing is a choice that must resonate with the values and preferences of the individual taking the medicine, alongside those of their caregivers and family members. The goals of care for the individual should be considered in the prescribing and deprescribing process. Every healthcare decision – whether it involves initiating, continuing, altering, or discontinuing treatment – necessitates informed consent from the individual or their supported decision-maker. To facilitate a truly informed decision, adequate and accurate information in relation to treatment options must be consistently provided in formats that are appropriate and accessible, taking into account specific communication needs of each person, including the possibility for fluctuating decisional capacity. This is particularly important for medicines taken on a regular basis, where the balance of risks, benefits, and alternative options may evolve over time.

As you engage with this guideline, remember the profound significance of centring individuals, their carers, and loved ones in decision-making. These are the people who best understand their personal circumstances, goals, and preferences, and whose lives will be directly impacted by any decisions.

We hope this guideline will serve as a valuable resource in your clinical practice, supporting informed, compassionate, and shared decision-making that truly prioritises the best interests of those you care for.