When a dose reduction or stop is planned for a patient in remission, agree beforehand with the patient and family what early warning signs look like, who they should contact and how soon the patient will be seen.
Write the plan in the notes. Early review in the first weeks, not only at the next routine appointment, makes it more likely that a relapse is caught while it is still small.
- Record the patient's own early warning signs before any reduction.
- Give the patient and family a named contact and a fast route to review.
- Reduce in steps and see the patient early after each change.
- Write down the criteria for returning to the previous dose.
Why it matters
Relapse after deprescribing is easier to manage when the plan exists before it starts.
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