Many prescriptions outlive the reason they were started. A beta-blocker begun after a heart attack a decade ago, a proton pump inhibitor added to cover dual antiplatelet therapy that has since stopped, aspirin continued alongside an anticoagulant: each can persist unquestioned for years.
At a medication review, ask of each drug what it is doing for the patient today, not what it was started for. If the original indication has passed and no new one exists, discuss stopping it.
Record the decision and the reason either way, so the next clinician does not have to repeat the exercise or quietly restart the drug.
- List each cardiovascular drug alongside its current indication
- Look for gastroprotection that has outlived its antiplatelet therapy
- Check for aspirin continued alongside an anticoagulant without a clear reason
- Record why a drug was continued or stopped
Why it matters
Deprescribing starts with noticing that the original indication has lapsed.
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