Deprescribing Unnecessary Medications: A Four-Part Process

Scott Endsley, MD


Fam Pract Manag. 2018;25(3):28-32. 

In This Article

Abstract and Introduction


Ms. Horatio is a 76-year-old patient who has been coming to your practice for more than 10 years. She has Type 2 diabetes with stage-3 chronic renal disease and painful diabetic neuropathy of bilateral lower extremities, chronic obstructive pulmonary disease, stable coronary artery disease, and hypertension. She has seen a cardiologist, pulmonologist, and neurologist for additional care. At today's visit with you, her family physician, she has brought a brown paper bag filled with all her medications per your request. Her medications include amitriptyline, atenolol, atorvastatin, low-dose aspirin, diphenhydramine hydrochloride, clopidogrel, conjugated estrogen tablets, ferrous sulfate, glyburide, isosorbide dinitrate, lisinopril, nifedipine extended release, omeprazole, paroxetine, pregabalin, tolterodine, tiotropium inhaler, and zolpidem. Where do you begin?