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The Andrew Herxheimer memorial lecture at the 2019 Paris general assembly of the International Society of Drug Bulletins, delivered by Alan Cassels (Communications Director, Therapeutics Initiative, University of British Columbia) and Dee Mangin (Professor of Family Medicine at McMaster University), focused on the burden of overprescribing. Both speakers provided a powerful reminder of the problem of inappropriate polypharmacy, the harms associated with medicines and the practical challenge of deprescribing. Of particular concern is the rise in the average number of medicines prescribed to older people and the emphasis that clinical guidelines (the majority of which deal with a single medical condition) have on starting drug treatment rather than rationalising, prioritising or stopping treatments.1–3 Healthcare systems continue to be …
Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).
Provenance and peer review Commissioned; externally peer reviewed.