Dear Jiyan Ma, I am very grateful for your insightful comments. Deprescribing is just a process of reducing inappropriate prescription/medication (not all medication) and should not be confused with the patient’s decision to discontinue their medication without clinicians’ decision. It only refers to discontinuing potential inappropriate medications through expertise decision and/or multidisciplinary medication review. Inappropriate prescriptions should be identified and de-prescribed as it increases the exposure to adverse drug effects, and medication-related hospitalization leading to increased health-related cost. However, during a decision process to discontinue medications by clinicians, the patient’s belief in their treatment might be affected and may not comply with clinical decisions. Hence, patients’ participation in the decision process is crucial.

In a resource-limited setting where access to NCD medication is minimal, reducing unnecessary medications (reducing medication burden) would enhance the patients’ ability to remember how to take their medications (medication-taking behaviour), quality of life, and reduce medication-related cost. Most importantly, De-prescribing is not reducing medications but a process of discontinuing inappropriate medications. We have also assessed prescribers’ attitude and practice in the de-prescribing process in another study.

With the rising prevalence of NCDs globally, describing clinical intervention seems at the first glance incompatible with the present needs, especially among the elder population. However, evidence is shown in this article about how many older patients present a significant attitude towards reducing medical intakes and the potential benefits linked to increasing medication adherence and quality of life. Healthcare providers should pay more attention to this topic under the comprehensive consideration of factors from both patients` and doctors` perspectives.

Older patients’ perception of deprescribing in resource-limited settings http://www.ncdaction.org/5417/older_patients_perception_of_deprescribing_in_resource_limited_settings?recruiter_id=5417