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Sunday 23 September 2018

Have you ever heard your doctor use the word “deprescribe?”

I recently saw this article on Diet Doctor site, written by Bret Scher, MD FACC and thought it one to share.

"I have been a doctor for over 20 years. I can tell I never heard it in medical school, residency or fellowship, and I have never heard a colleague use it. Why is that? 

Our medical culture is far too focused on prescribing medications to temper our symptoms or make our lab numbers look better. The result is we frequently fail to see if the medication actually helps us achieve better heath. 

A recent article in gives us hope that we are starting to change this. 

The article explains how hundreds of primary care doctors in the UK are joining forces to publicly emphasize the importance of lifestyle changes over drug prescriptions. A movement like this cannot come soon enough. 

In the U.S., for instance, it is estimated that 60% of the adult population takes a prescription drug, and 15% take more than five. This is despite the fact that nutrition and exercise are equally or more effective than drugs for treating common conditions such as depression and hypertension

An even bigger example is the prescription of statins for lowering cholesterol. The UK study cited 11 million prescriptions in 2007 increasing to 37 million in 2017 for atorvastatin alone. This is despite the fact that treating 217 people for five years with a statin prevents only one heart attack. 

Said another way, 216 of those taking statins did not benefit, yet still had the potential for side effects and had the cost and inconvenience of taking the drug. Based on those numbers, it is long overdue for us to reevaluate our statin use. And just to show no drug is completely safe, even aspirin is more complicated than we thought. Recent studies in NEJM showed aspirin has no overall benefit for primary prevention in those with diabetes, and two studies showed no benefit for those over age 70

What can we make of all this? It is encouraging that groups of doctors are speaking out in favor of lifestyle, not drugs, as first line treatment. Combined with the growing body of evidence that low carb diets can reverse type II diabetes, the movement for fewer prescriptions allows doctors to focus on what really works- nutrition, physical activity, sleep hygiene, stress management, and other essential healthy lifestyle practices. 

Next time you see your doctor, ask them when the last time was they used the word “deprescribe.” Hopefully, just by asking the question, you will help your doctor use that word more often in the future. That’s a movement I can support! 

Thanks for reading"

All the best Jan


Elephant's Child said...

Sadly I think it is a word/concept that most doctors the world over need to make better use of.

Chris Lally said...

I "deprescribed" my former doctor, though I don't recommend that people with serious health problems do that, of course.
I got tired of him saying, "The benefits of taking this drug outweigh the risk."

Christine said...

They are more likely to double people's prescriptions than to deprescribe.

peppylady (Dora) said...

Personally never heard a doctor or any medical people use the term "Deprescribe"
Coffee is on

Anonymous said...

No, and think for most Doctors highly improbable. As stated -medical culture is far too focused on prescribing medications-

Debbie said...

interesting, but not logical for me, or my doctor!!

Sami said...

Interesting article Jan.

Linda said...

I haven't heard the word before this. I agree that life style changes are crucial.

handmade by amalia said...

A healthy lifestyle is indeed the best prevention. I am always amazed at the amount of drugs available freely in the drugstore, even without a prescription.

Valerie-Jael said...

This is very good information. Hugs, Valerie

Heloise said...

I think a huge issue is that many patients expect to be given a prescription and an easy way to get them out of your consulting room is to oblige them. Certainly, this approach is why we are reaching a crisis point with antibiotics: they have been prescribed inappropriately for decades and we are becoming resistant to them.


William Kendall said...

I never have.

Magic Love Crow said...

I have never heard of this word before, and I think it should be used more often! Big Hugs!