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Deprescribing in patients with multimorbidity: A necessary process

      As featured in several publications, the term deprescribing has not yet been standardized [
      • Revee E.
      • Shakib S.
      • Hendrix I.
      • Roberts M.S.
      • Wiese M.D.
      Review of deprescribing processes and development of an evidence-based, patient-centred deprescribing process.
      ], and different points of view have thus been used to define it. One of the first concepts came from Woodward [
      • Woodward
      Deprescribing: achieving better health outcomes for older people through reducing medications.
      ], who described the principles on which deprescribing is based within the framework of safe medication use in 2003, from which time the term began to spread. In 2011, Le Couteur et al. [
      • Le Couteur D.G.
      • Banks E.
      • Gnjidic D.
      • McLachlan A.
      Deprescribing.
      ], defined it as “the cessation of long-term therapy, supervised by a clinician”, while Scott et al. [
      • Scott I.A.
      • Gray L.C.
      • Martin J.H.
      • Pillans P.I.
      • Mitchell C.A.
      Deciding when to stop: towards evidence based deprescribing of drugs in older populations.
      ] described it as “discontinuing medications with questionable or no evidence of efficacy, unfavorable risk/benefit ratios, or those that the patient desires to avoid”. More recent publications have focused on deprescribing as a prescription appropriateness assessment process. Thus, Gavilán et al. [
      • Gavilán-Moral E.
      • Villafaina-Barroso A.
      • Jiménez-de Gracia L.
      • Gómez Santana M.C.
      Ancianos frágiles polimedicados: ¿es la deprescripción de medicamentos la salida?.
      ] consider it “a prescription analysis that can lead to dosage adjustment, substitution, or the discontinuation of certain drugs and the incorporation of others”.

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