From Polypharmacy to Patient Safety: A Practical Roadmap for Deprescribing in Daily Practice
Jose-Miguel BUENO-ORTIZ, Maria-Pilar ASTIER-PEÑA, Jose-Maria VALDERAS, Andree ROCHFORT, Dorien ZWART, Oana BULILandE, Sara ARES-BLANCO, Josep-Maria VILASECA and Ana-Maria CEBRIAN-CUENCA
Deprescribing (D) is a critical patient safety intervention, particularly for elderly patients where polypharmacy (>10 drugs) significantly increases the risk of adverse events. Beyond individual safety, D aligns with One Health and Planetary Health principles. Reducing unnecessary medication use directly mitigates pharmaceutical pollution in water systems and lowers the carbon footprint associated with global drug manufacturing and distribution. This joint workshop—led by experts from EQUIP, EGPRN, WONCA WP on Quality and Safety, on Research and on Planetary Health and WONCA SIG on non-communicable diseases—applies validated frameworks (e.g., Beers/STOPP-START criteria) to shift the clinical paradigm toward optimizing therapy for both patient and planet.Identify and manage "therapeutic cascades" to improve clinical safety and environmental sustainability. Evaluate evidence to safely stop harmful medications, reducing the pharmaceutical load on the environment. Master communication strategies to empower patients in shared decision-making regarding "Green Deprescribing." Develop a transferable plan for immediate implementation in participants' home practices.We employ an active-engagement pedagogy. Following an evidence-based briefing on clinical and planetary benefits, participants engage in facilitator-led small-group work: 00-10m: Introduction: Clinical safety and Planetary Health context. 10-15m: High-fidelity clinical case presentation. 15-40m: Interactive breakout groups: Solving dilemmas using D-resources. 40-50m: Plenary sharing: Synthesizing group proposals. 50-60m: Take-home messages and resource distribution.Participants will gain actionable insights and a Deprescribing Toolkit. Outcomes are highly transferable: attendees will leave with the skills to lead medication reviews that improve patient quality of life while contributing to healthcare sustainability.The GP’s role in deprescribing is paramount. This workshop provides the tools to bridge the gap between theoretical safety and daily practice, ensuring a wiser, safer, and more sustainable future for primary care. Keywords: Deprescriptions, Patient Safety, Polypharmacy, One Health, Environmental Health
