Australian clinical guideline for deprescribing in older people

Deprescribing* is integral to good prescribing practice, but it can be challenging and there is limited guidance available. In September 2025, the University of Western Australia published a new clinical guideline for deprescribing medicines in older people.¹ While deprescribing is relevant to patients of all ages, the guideline focuses on older people because they face greater risk of drug-related harm due to the higher prevalence of multimorbidity, polypharmacy and potentially inappropriate medicines.

The guideline was developed using methodology adapted from the National Health and Medical Research Council standards for clinical practice guidelines and the Appraisal of Guidelines for Research and Evaluation II.¹ Due to limited availability of high-quality evidence to inform recommendations, a Delphi consensus process was used to reach agreement on recommendations and practice statements. Consensus required at least 75% agreement among a 72-member multidisciplinary guideline development group. The guideline underwent public consultation and peer review.

There are recommendations and good practice statements provided for more than 30 drug classes commonly used by older people, complementing existing drug-specific and disease-specific therapeutic guidelines. There are also recommendations and practice statements addressing polypharmacy or multiple drug classes.

In total, there are 185 recommendations and 70 good practice statements. The guideline promotes shared decision-making, involving the patient and their general practitioner and/or other specialist, to ensure deprescribing decisions align with the patient's preferences, goals and overall treatment plan.

The guideline has been endorsed by several professional colleges and societies, including the Australian and New Zealand Society for Geriatric Medicine and the Royal Australian College of General Practitioners.

While the intended audience for the guideline is healthcare professionals, the authors plan to develop consumer-friendly resources that will complement the guideline.

The guideline,¹ along with background information and a technical summary, is available at the guideline website.

* Deprescribing is a person-centred process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required.¹

 

References

1. Quek HW, Perello X, Lee K, Etherton-Beer C, Page AT, Guideline Development Group. Deprescribing in older people: a clinical practice guideline. Perth: The University of Western Australia; 2025.