A simple search of PubMed reveals striking insight. Querying the term prescribing yields 44 379 hits. In contrast, deprescribing yields only 672. Completing this exercise for a neurological condition such as epilepsy prescribing and epilepsy deprescribing yields similar results: 408 hits for the former and 3 for the latter. While this search is clearly overly simplistic, it illustrates a crucial point: attention is tremendously imbalanced.

What is the result? Half of US adults older than 65 years take 5 or more medications.¹ It is no surprise that one survey found 67% of patients wanted to reduce their number of daily pills and 92% would be willing to stop a medication if their physician said it was possible.¹ The emerging field of deprescribing—the systematic process of discontinuing drugs where harms outweigh benefits in the context of an individual patient’s values—seeks to rescue patients and clinicians alike.

简单搜索PubMed即可发现惊人的洞察力。查询“处方”一词可产生44 379次匹配。相比之下，开处方仅产生672次。针对神经系统疾病（如癫痫开处方和癫痫开处方）完成此练习可获得相似的结果：前者408次，后者3次。尽管此搜索显然过于简单，但它说明了一个关键点：注意力极为不平衡。

结果是什么？65岁以上的美国成年人中有一半服用5种或以上药物。¹一项调查发现67％的患者希望减少每日服药的数量，而92％的患者愿意在医生表示可能的情况下停止服药也就不足为奇了。¹处方药的新兴领域-在个体患者价值观的背景下中止药物性危害的系统性过程-寻求抢救患者和临床医生。