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Deprescribing needs to be considered in the pharmacists’ prescribing role

Lisa Kouladjian O'Donnell and Mouna J Sawan
Med J Aust 2020; 212 (3): . || doi: 10.5694/mja2.50461
Published online: 17 February 2020

To the Editor: Pharmacist prescribing rights in Australia have recently sparked debate between medical practitioners and pharmacists.1 While discussion on the potential role of pharmacists to prescribe is important, the debate has focused on the initiation of medications. There is a need to acknowledge that prescribing is a process, which, according to the World Health Organization's six‐step Guide to good prescribing, includes “Step 6: Monitor (and stop?) the treatment”.2 Given inappropriate polypharmacy is increasing in older people,3 collaborative deprescribing (defined as the supervised withdrawal of inappropriate medications) with pharmacists, medical practitioners, and patients should therefore be given equal priority within this debate.


  • 1 National Health and Medical Research Council Cognitive Decline Partnership Centre, University of Sydney, Sydney, NSW
  • 2 Kolling Institute, Royal North Shore Hospital, Sydney, NSW
  • 3 University of Sydney, Sydney, NSW



Competing interests:

No relevant disclosures.

  • 1. Yim N. Widening pharmacists’ scope: a prescription for trouble Australia. InSight+ 2019; 27 May. https://insightplus.mja.com.au/2019/20/widening-pharmacists-scope-a-prescription-for-trouble (viewed July 2019).
  • 2. De Vries TP, Henning RH, Hogerezeil HV, Fresle DA. Guide to good prescribing: a practical manual. Geneva: World Health Organization, 1994. https://apps.who.int/medicinedocs/en/d/Jwhozip23e/; (viewed Dec 2019).
  • 3. Page AT, Falster MO, Litchfield M, et al. Polypharmacy among older Australians, 2006–2017: a population‐based study. Med J Aust 2019; 211: 71–75. https://www.mja.com.au/journal/2019/211/2/polypharmacy-among-older-australians-2006-2017-population-based-study;.
  • 4. Inch J, Notman F, Bond CM, et al. The Care Home Independent Prescribing Pharmacist Study (CHIPPS) — a non‐randomised feasibility study of independent pharmacist prescribing in care homes. Pilot Feasibility Stud 2019; 5: 89.
  • 5. Raghunandan R, Tordoff J, Smith A. Non‐medical prescribing in New Zealand: an overview of prescribing rights, service delivery models and training. Ther Adv Drug Saf 2017; 8: 349–360.
  • 6. Zhou M, Desborough J, Parkinson A, et al. Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences. Int J Pharm Pract 2019; 27: 479–489.

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