New clinical practice guidelines will transform how medicines are prescribed for older Australians, helping to reduce harm and improve quality of life.
Published in the Medical Journal of Australia, the Deprescribing in Older People: A Clinical Practice Guideline Summary provides a comprehensive guide on when and how medicines can be safely reduced or stopped in people aged 65 and over.
Developed by a multidisciplinary team of 72 experts including clinicians, researchers, and consumer representatives, the guidelines respond to growing concerns around polypharmacy, where individuals are prescribed multiple medications that may no longer be necessary or beneficial.
Older people are particularly vulnerable to medicine-related harm, with long-term prescriptions often continued without regular review. The new guidelines aim to address this critical gap by embedding deprescribing as a routine part of patient care.
University of Notre Dame Australia’s Institute for Health Research and co-author of the summary, Professor Osvaldo Almeida said the guidelines mark an important shift in clinical thinking.
“Prescribing should not be a one-way process,” he said.
“These guidelines encourage clinicians to regularly review medications and consider whether they are still needed, balancing benefits and risks as a person’s health and circumstances change.”
The guidelines provide 185 consensus-based recommendations and 70 good practice statements, structured around four key areas: when to deprescribe, assessing ongoing treatment needs, how to deprescribe, and monitoring after medicines are reduced or stopped.
Importantly, they emphasise shared decision-making, ensuring patients, families, and carers are actively involved in decisions about their treatment.
Evidence reviewed for the guidelines shows that deprescribing can reduce treatment burden and improve medicine adherence, without increasing risks such as hospitalisation or mortality when done appropriately under medical supervision.
The University of Western Australia PhD candidate and lead author of the summary Hui Wen Quek said the guidelines helped support health professionals in navigating what can often be a complex process.
“Many clinicians recognise the benefits of deprescribing but lack clear guidance. These recommendations provide a structured, practical approach to reviewing medications and minimising harm,” she said.
The guidelines also highlight broader benefits, including potential cost savings for the healthcare system and improved quality use of medicines. International estimates suggest optimising polypharmacy could prevent billions of dollars in avoidable healthcare spending each year.
Endorsed by leading national organisations including the Royal Australian College of General Practitioners (RACGP) and the Australian and New Zealand Society for Geriatric Medicine (ANZSGM), the guidelines are expected to play a key role in improving care for Australia’s ageing population.
Read the full paper here
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