Deprescribing in Primary Care: Aligning Medication Regimens With Patient Goals
At Practical Updates in Primary Care, W. Clay Jackson, MD, DipTh, and Nicole Brandt will present “Polypharmacy in Primary Care: Practical Strategies for Safer Prescribing and Deprescribing.” The session will address the growing prevalence of polypharmacy in primary care, particularly among older adults and patients with multiple chronic conditions. Although many medications are evidence-based, cumulative prescribing can increase the risk of adverse drug events, falls, hospitalizations, and reduced quality of life. Through case-based discussion and actionable tools, the session will provide practical, evidence-informed strategies to identify high-risk patients, conduct efficient medication reviews, implement safe deprescribing, and optimize medication regimens while aligning treatment decisions with patient goals of care.
Consultant360: What are some of the key themes of your presentation?
W. Clay Jackson, MD, DipTh: All prescriptions are trials--we shouldn't view pharmacotherapy as a lifetime contract with a non-compete clause. During each patient visit, we should look at each medication to assess whether ongoing therapy at a given dose makes sense for that patient in his/her current condition, and carefully weigh safety, efficacy, and tolerability with a shared decision-making approach.
Consultant360: Why is this topic particularly relevant right now?
Dr Jackson: There's an increased emphasis on patient safety, and a public interest in minimizing prescription drug burden if possible. The HHS Secretary has indicated recently that CMS may offer additional remuneration for patient visits that include documented efforts toward deprescribing. We can capture that momentum to have engaging conversations with our patients about what's important to them in their health journey.
Consultant360: What are the most important takeaways from your session?
Dr Jackson: For deprescribing, it's direction, not speed, that's important. Shared decision-making, not unmitigated patient autonomy or unbridled paternalism, offers the best therapeutic framework from which to consider deprescribing.
Consultant360: What gaps in our knowledge do you feel still remain on this topic?
Dr Jackson: I think the current research has been focused more on qualitative gains (going off medications), and we could use more studies that look at quantitative gains (e.g., lower doses).
Consultant360: Anything else you would like to add?
Dr Jackson: People don't believe in clinicians because of medicines; they believe in medicines because of clinicians. Folks who do a good job at establishing rapport are going to have the most success when it comes time to consider deprescribing.
Reference
Jackson WC, Brandt N. Polypharmacy in Primary Care: Practical Strategies for Safer Prescribing and Deprescribing. Practical Updates in Primary Care 2026 Agenda. HMP Global. Accessed May 15, 2026. https://www.hmpglobalevents.com/pupc/agenda