Informing deprescribing decisions in older people: does the Product Information contain advice on medication use for older people and medication withdrawal?

Abstract

AbstractBackgroundProduct Information (PI) details the indications for prescribing, dosage and administration, and recognised side effects and contraindications. No formal requirement exists for PI to include information on medication use in older people and what to expect while withdrawing medication (deprescribing). Deprescribing has a focus on older people, so we designed this study to evaluate how frequently the PI includes information on medication withdrawal and medication use in older people.MethodsWe identified PIs currently available from the Therapeutic Goods Administration website for medications commonly used by older people. Data were abstracted using data extraction tables for eight categories of information, including statements of possible withdrawal effects, specified advice on discontinuation strategies and specified advice for older people.ResultsWe retrieved the PI for 99 different medications. Statements of possible withdrawal effects were provided in half of the PIs (n = 57). Of these, three PIs specified scenarios that constituted clinical criteria for withdrawal of the medication from long‐term use. The majority of PIs (n = 73) did not provide specified advice on discontinuation strategies. Of these medications, 23 PIs provided specific recommendations and three PIs made a general recommendation to gradually withdraw medication.DiscussionAlmost all the PIs reviewed included information about medication use in older people, but only half included information about medication withdrawal. The inclusion of information about discontinuation effects and strategies may improve PIs.