AI Deprescribing Advisor

It is common for people to be prescribed many medications and also to take over-the-counter treatments, vitamins, or supplements. Medications are often started for a good reason, but sometimes they are continued when they are no longer helpful and may cause adverse effects. Slowly and carefully cutting down on unnecessary medications with the help of a health care service is called deprescribing.

The AI deprescribing advisor is a chat interface that is highly trained on rigorous clinical deprescribing protocols. It will communicate with you in natural language to evaluate if your medication is a suitable candidate to be deprescribed. If the AI Deprescribing Advisor recommends that your medication is suitable for deprescribing, then it will generate a report that you can give to your doctor. The report explains to your doctor the rationale for the deprescribing advice and what they need to do next to safely withdraw or stop your medication. Under NO circumstances should you STOP or WITHDRAW your medication, until you have discussed the report with your doctor.

Not all medications are covered by the evidence-based deprescribing protocols. The medication classes that are covered by the AI Deprescribing Advisor are:

• Anticholinergic Medications
• Proton Pump Inhibitors Medications
• Anti-hyperglycemic Medications
• Antipsychotic Medications
• Benzodiazepine & Z-Drug Medications
• Cholinesterase Inhibitor Medications & Memantine

The AI deprescribing advisor can help advise your doctor on how to reduce the dose or stop the affected medication due to it not providing substantial benefit, or because the medication carries considerable risk of negative health effects.

Taking fewer medications could help you feel better for several reasons.

• Lower the number of medications you have to take every day.
• Save you or the health system money.
• Increase your ability to reliably take the medications that do provide benefits.
• Decrease the risk of dangerous adverse effects and improve your quality of life.

The decision to deprescribe a medication must only be made by your supervising doctor. Your doctor may decide that some medications can be safely stopped immediately. Others need to be slowly decreased, or “tapered,” a bit at a time. Tapering can help your body get used to not taking certain medications, preventing any withdrawal effects. If you are advised to deprescribe, you will be generated a report that you should share with your doctor. The report contains important information for your doctor, which can help them decide how to safely and effectively withdraw or stop your medication.

Some medications may be deprescribed by a doctor because they do not have any benefit (eg, stool softeners, certain supplements and vitamins). Other medications may be deprescribed because they can have dangerous adverse effects. Some medications may be deprescribed because long-term use can lead to health problems. Some medical conditions do not need to be as tightly controlled with age. For example, it is possible to deprescribe some medications for diabetes, cholesterol, or high blood pressure.

The AI Deprescribing Advisor has been developed and trained on evidence-based deprescribing guidelines

• Anticholinergic (AC) Deprescribing – NSW Therapeutic Advisory Group which is an initiative of NSW clinical pharmacologists & pharmacists.
• Proton Pump Inhibitor (PPI) Deprescribing – B, Pottie K, Thompson W, Boghossian T, Pizzola L, Rashid FJ, et al. Deprescribing proton pump inhibitors. based clinical practice guideline. Can Fam Physician 2017;63:354-64 (Eng), e253-65 (Fr).
• Antihyperglycemics Deprescribing – Farrell B, Black C, Thompson W, McCarthy L, Rojas-Fernandez C, Lochnan H, et al. Deprescribing antihyperglycemicagents in older persons. Evidence-based clinical practice guideline. Can Fam Physician 2017;63:832-43 (Eng), e452-65 (Fr).
• Antipsychotic (AP) Deprescribing – Bjerre LM, Farrell B, Hogel M, Graham L, Lemay G, McCarthy L, et al. Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline. Can Fam Physician 2018;64:17-27 (Eng), e1-e12 (Fr).
• Benzodiazepine & Z-Drug (BZRA) Deprescribing – Evidence-based clinical practice guideline for deprescribing benzodiazepine receptor agonists. Can Fam Physician 2018;64:339-51 (Eng), e209-24 (Fr)
• Cholinesterase Inhibitor (ChEI) and Memantine Deprescribing – Reeve E, Farrell B, Thompson W, at al Evidence-based Clinical Practice Guideline for Deprescribing Cholinesterase Inhibitors and Memantine. 2018.ISBN-13: 978-0-6482658-0-1