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Polypharmacy, Appropriate Prescribing, and Deprescribing

A Clinician’s Guide

  • 1st Edition - July 22, 2026
  • Latest edition
  • Authors: Gregory J. Hughes, Demetra Antimisiaris
  • Language: English

Medication use is at an all-time high, especially in aging populations, and medication harm is one of the few preventable causes of harm in medicine. Polypharmacy, Appropriate Pr… Read more

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Description

Medication use is at an all-time high, especially in aging populations, and medication harm is one of the few preventable causes of harm in medicine. Polypharmacy, Appropriate Prescribing, and Deprescribing: A Clinician’s Guide is a first-of-its kind resource that provides clinicians and trainees with current, authoritative guidance and skill-building insights on how and when to use the right medications, and how and when medications should be stopped. This timely, instructive text is a must-have reference for a wide variety of healthcare practitioners and is particularly useful in the outpatient office where the majority of chronic medication prescribing and reviewing takes place. The text is an essential educational resource now and in the future as the burden of polypharmacy continues to expand globally.

Key features

  • Addresses polypharmacy not only in geriatric patients, but across the lifespan, including younger adults, patients with intellectual and developmental disabilities, and those with life-limiting conditions
  • Approaches polypharmacy from a unique, systems- and process-based approach, covering each system’s polypharmacy nuances in addition to evidence-based polypharmacy criteria, and teaching skills that are repeatable throughout different clinical disciplines and systems of the body
  • Contains decision-making algorithms in each systems-based chapter, including polypharmacy related to CNS, cardiovascular, endocrine and metabolic, hematology/oncology, and infectious disease, as well as polypharmacy in palliative care
  • Includes most common scenarios encountered in each body system, covering how to work through classic examples of the polypharmacy problems that occur in that system. These examples are individually valuable because of their commonality, but also reinforce a structured approach toward any other polypharmacy problem
  • Discusses practical, real-world issues such as how to manage polypharmacy in short clinical visits, and future directions in deprescribing and medication optimization
  • An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, make notes and highlights, and have content read aloud. Additional digital ancillary content may publish after the publication date

Readership

Internal Medicine, family medicine, geriatrics

Table of contents

PART 1 Introduction to Polypharmacy

1 Introduction

2 Systematic and Systemic Factors in Polypharmacy

3 Managing Polypharmacy: Undeterred by the 15-Minute Office Visit

PART 2 Polypharmacy by System or Therapeutic Area

4 Central Nervous System

5 Cardiovascular

6 Dermatologic

7 Ear, Nose, and Throat

8 Endocrine

9 Gastrointestinal

10 Hematology/Oncology

11 Infectious Diseases

12 Musculoskeletal

13 Pulmonary

14 Renal

15 Polypharmacy in Palliative Care

PART 3 Future Directions

16 The Future of Polypharmacy Management, Deprescribing, and Medication Optimization—Where Next?
Index

Product details

  • Edition: 1
  • Latest edition
  • Published: November 3, 2026
  • Language: English

About the authors

GH

Gregory J. Hughes

Gregory J. Hughes, PharmD, BCPS, BCGP, is a Clinical Professor in the Department of Pharmacy Practice at St. John's University College of Pharmacy and Health Sciences where he has held academic leadership positions. He is also an Assistant Professor in the Department of Medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. Dr. Hughes serves as a Clinical Pharmacy Preceptor in the Department of General Internal Medicine at North Shore University Hospital, where he provides pharmacotherapy expertise to the inpatient internal medicine service and has precepted more than 300 pharmacy students and dozens of pharmacy residents. He is author of numerous peer-review articles, book chapters, and is the creator and editor of the textbook A Medication Guide to Internal Medicine Tests and Procedures and an Assistant Editor for The Senior Care Pharmacist journal. His professional expertise and research focus on internal medicine, geriatrics, pedagogy, and assessment. Dr. Hughes completed a post-graduate Pharmacy Practice Residency at the St. Louis VA Medical Center and served as a Clinical Instructor at the St. Louis College of Pharmacy during that time.”

Affiliations and expertise
Clinical Professor | Department of Pharmacy Practice, St. John’s University College of Pharmacy and Health Sciences, Assistant Professor | Department of Medicine,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

DA

Demetra Antimisiaris

Demetra Antimisiaris, PharmD, BCGP, FASCP, is an Associate Professor in the Departments of Health Management and Systems Sciences, Family and Geriatric Medicine, and Neurology at the University of Louisville Schools of Public Health and Medicine. She also serves as Director of the University of Louisville’s Frazier Polypharmacy Program, which focuses on education, research, and outreach to address the growing challenges of polypharmacy.

Dr. Antimisiaris completed a geriatric pharmacy residency in 1990 at the VA Medical Center in Sepulveda, California, a UCLA geriatrics training site and part of the Greater Los Angeles Geriatric Research, Education, and Clinical Center (LA-GRECC). This program placed particular emphasis on addressing polypharmacy, shaping her long-standing focus in this area. Before entering academia mid-career, she worked as a consultant pharmacist.

Her research interests include multi-stakeholder approaches to medication use, health system drivers of polypharmacy, and medication-use risk modeling. She has authored numerous publications, serves as Assistant Dean of Continuing Medical Education (CME), contributes to NSF- and NIH-funded research projects, and provides a polypharmacy consultation service.

Dr. Antimisiaris has made significant contributions to education related to polypharmacy. Her work includes developing interprofessional education programs for healthcare learners, leading conference workshops, and teaching across undergraduate, graduate and post-graduate programs in medicine, dentistry, pharmacy, physician assistant, athletic trainer, social work, psychology and nursing.

Affiliations and expertise
Associate Professor in the Departments of Health Management and Systems Sciences, Family and Geriatric Medicine, and Neurology at the University of Louisville Schools of Public Health and Medicine. Fulbright Specialist, Polypharmacy, U.S. Department of State, Fulbright Specialist Program. Faculty and past co-chair, UCLA Intensive Course in Geriatrics. Adjunct Professor and preceptor, University of Kentucky College of Pharmacy. Faculty Chair and content author- MTM certificate programs.