In many cases, the concurrent use of multiple medications is a reality of disease management. However, each additional medication being used changes the clinical picture of individual patients. Can we create balance between the right medications and the burden of too many medications?

Deprescribing means reducing or stopping medications that may not be beneficial or may be causing harm. The goal of deprescribing is to maintain or improve quality of life. Deprescribing involves patients, caregivers, healthcare providers and policy makers.

OPEN researchers focus on optimizing all medication use and understanding how concomitant medications alter risk-benefit profiles, social costs, patient/caregiver burden. Identifying opportunities for deprescribing, developing tapering strategies, and balancing the potential impacts of continued use with those of discontinuation are ongoing priorities for OPEN research teams.

• OPEN has successfully developed guidelines for deprescribing drugs such as proton pump inhibitors (PPIs), benzodiazepines, and antipsychotics.
• Many of these projects include outputs that are tailored specifically for unique patient groups/environments such as long-term care and are in practical formats for healthcare providers.

This research empowers providers to use interprofessional collaboration and simplified patient-centred care when examining a patient’s drug regimen, and has led to new partnerships with organizations such as the Canadian Deprescribing Network.

The evidence-based guidelines and their algorithms, developed by the Bruyère Research Institute Deprescribing Guidelines Research Team and its collaborators, are products of quality research and real-world application. Evidence-based deprescribing guidelines have been developed by or in collaboration with the Bruyère Research Institute for five classes of medications.

Decisions around deprescribing can be very difficult. Few evidence-based guidelines exist to support safe deprescribing for specific classes of medication. Researchers from the Bruyère Research Institute and the Ontario Pharmacy Research Collaboration developed evidence-based guidelines for deprescribing. Each guideline is summarized in an easy-to-use algorithm and information brochure. These algorithms can help health care professionals safely stop or reduce medications for specific drug classes.

Each algorithm provides evidence for the benefits and harms of continuing or deprescribing the medications. The algorithms also take into account patient preferences and values surrounding deprescribing, together with practical advice on how to implement deprescribing.

Please use the above algorithms freely, with credit to the authors. The algorithms are not for commercial use and are licensed under a Creative Commons Attribution-Noncommercial-ShareAlike 4.0 International License. Do not modify or translate without permission. For more information, please contact deprescribing@bruyere.org.