What Is Deprescribing?
It is common for people to be prescribed many medications and also to take over-the-counter treatments, vitamins, or supplements. Medications are often started for a good reason, but sometimes they are continued when they are no longer helpful and may even cause adverse effects. Slowly and carefully cutting down on unnecessary medications with the help of a healthcare service is called deprescribing.
The final decision to deprescribe a medication must only be made by your supervising doctor. Your doctor may decide that some medications can be safely stopped immediately. Others need to be slowly decreased or “tapered” a bit at a time. Tapering helps your body adjust to not taking certain medications, preventing withdrawal effects.
How Does the AI Deprescribing Advisor Work?
The AI Deprescribing Advisor is a chat interface that has been highly trained on rigorous clinical deprescribing protocols. It communicates with you in natural language to evaluate whether your medication is a suitable candidate for deprescribing.
If the AI Deprescribing Advisor recommends that your medication is suitable for deprescribing, it will generate a report that you can share with your doctor. The report explains to your doctor the rationale for the deprescribing advice and what they need to do next to safely withdraw or stop your medication.
Important: Under NO circumstances should you STOP or WITHDRAW your medication until you have discussed the report with your doctor.
How to Use the AI Deprescribing Advisor
Using the AI Deprescribing Advisor is straightforward:
Navigate to the AI Deprescribing Advisor Service Card, which is located on your account homepage
Select ‘Start AI Consultation’ from the Options menu
The AI Deprescribing Advisor will conduct a natural language consultation with you
After the consultation, If the AI Deprescribing Advisor finds that one or more of the medications you take, are suitable candidates for deprescribing, It will advise you as such
You will receive a notification if and when your report is ready. The report will be available in your Documents folder
Share the report with your doctor to decide on the next steps
Which Medications Can Be Deprescribed?
Not all medications are covered by the evidence-based deprescribing protocols. The medication classes covered by the AI Deprescribing Advisor are:
Anticholinergic Medications
Proton Pump Inhibitors Medications
Anti-hyperglycemic Medications
Antipsychotic Medications
Benzodiazepine & Z-Drug Medications
Cholinesterase Inhibitor Medications & Memantine
The AI Deprescribing Advisor can help advise your doctor on how to reduce the dose or stop the affected medication because it is not providing substantial benefit, or because it carries considerable risk of negative health effects.
What Are the Benefits of Deprescribing?
Taking fewer medications could help you feel better for several reasons. Deprescribing may:
Lower the number of medications you have to take every day
Save you or the health system money by reducing hospital admissions
Increase your ability to reliably take the medications that do provide benefits
Decrease the risk of dangerous adverse effects and improve your quality of life
What Are Common Examples of Deprescribing?
Some medications may be deprescribed by a doctor because they do not provide any benefit, for example, stool softeners, certain supplements, and vitamins. Other medications may be deprescribed because they can have dangerous adverse effects, or because long-term use can lead to health problems.
Some medical conditions also do not need to be as tightly controlled with age. For example, it is possible to deprescribe some medications for diabetes, cholesterol, or high blood pressure when the clinical picture changes over time.
What Are the Evidence Bases for Each Deprescribing Protocol?
The AI Deprescribing Advisor has been developed and trained on the following evidence-based deprescribing guidelines:
Anticholinergic (AC) Deprescribing
NSW Therapeutic Advisory Group, which is an initiative of NSW clinical pharmacologists & pharmacists.
Proton Pump Inhibitor (PPI) Deprescribing
B, Pottie K, Thompson W, Boghossian T, Pizzola L, Rashid FJ, et al. Deprescribing proton pump inhibitors. based clinical practice guideline. Can Fam Physician 2017;63:354-64 (Eng), e253-65 (Fr).
Antihyperglycemics Deprescribing
Farrell B, Black C, Thompson W, McCarthy L, Rojas-Fernandez C, Lochnan H, et al. Deprescribing antihyperglycemic agents in older persons. Evidence-based clinical practice guideline. Can Fam Physician 2017;63:832-43 (Eng), e452-65 (Fr).
Antipsychotic (AP) Deprescribing
Bjerre LM, Farrell B, Hogel M, Graham L, Lemay G, McCarthy L, et al. Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline. Can Fam Physician 2018;64:17-27 (Eng), e1-e12 (Fr).
Benzodiazepine & Z-Drug (BZRA) Deprescribing
Evidence-based clinical practice guideline for deprescribing benzodiazepine receptor agonists. Can Fam Physician 2018;64:339-51 (Eng), e209-24 (Fr).
Cholinesterase Inhibitor (ChEI) and Memantine Deprescribing
Reeve E, Farrell B, Thompson W, at al. Evidence-based Clinical Practice Guideline for Deprescribing Cholinesterase Inhibitors and Memantine. 2018. ISBN-13: 978-0-6482658-0-1.
Is the AI Deprescribing Advisor Safe to Use?
Yes. The AI Deprescribing Advisor is classified as a Class I medical device under UK MDR 2002 regulations for its intended use.
The tool generates a report and recommendations for your doctor. It does not make prescribing or deprescribing decisions on your behalf. All deprescribing decisions must be made by your supervising doctor after reviewing your report. Do not stop or change any medication without first discussing the report with your doctor.