In a geriatric pharmacotherapy review, what is the goal of deprescribing?

• A. Minimize harmful polypharmacy and adverse effects while preserving beneficial therapies.
• B. Increase medication count to cover all conditions.
• C. Eliminate all medications.
• D. Switch all medications to over-the-counter.

Answer: (A)

Deprescribing focuses on reducing the medication burden to improve safety and quality of life for older adults. In industry terms, the goal is to minimize harmful polypharmacy and adverse effects while preserving therapies that still provide meaningful benefit or symptom control, and that align with the patient’s goals and life expectancy.

In geriatrics, medications often continue beyond their current need, increasing risks like drug interactions, cognitive impairment, falls, and kidney or liver strain. A purposeful deprescribing plan reassesses each medicine’s current benefit versus risk, considering the person’s goals, overall health, and daily function. If a drug no longer offers meaningful benefit or poses more harm than good, it can be safely reduced or stopped, sometimes with a gradual taper to avoid withdrawal and to monitor for changes.

This approach isn’t about eliminating all meds or replacing every prescription with over-the-counter options, nor about simply adding more drugs to “cover” conditions. It’s about thoughtful, patient-centered simplification that preserves what truly helps and aligns with the individual’s priorities.