Deprescribing Guidelines and Algorithms

Watch our video to learn how the Bruyère team developed each of the evidence-based deprescribing guidelines.

This video helps viewers understand:

The rationale for evidence-based deprescribing guidelines
The process used for developing the deprescribing guidelines
The steps that a health care professional and patient need to go through to make and carry out safe deprescribing processes

Guidelines and Algorithms

Evidence-based deprescribing guidelines have been developed by or in collaboration with the Bruyère Research Institute for five classes of medications. Each guideline is accompanied by a decision-support algorithm, patient pamphlet, infographic and for some, a whiteboard video on how to use the algorithm.

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Proton Pump Inhibitor (PPI)

Proton pump inhibitors – or PPIs – are a class of drugs used to treat heartburn, gastroesophageal reflux disease and gastric ulcers. PPIs reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid

Proton Pump Inhibitor evidence-based deprescribing guideline (published in Canadian Family Physician)
Proton Pump Inhibitor deprescribing algorithm
Proton pump inhibitor deprescribing guideline information pamphlet
Proton pump inhibitor deprescribing infographic
Proton pump inhibitor patient decision aid
Whiteboard video on using the Proton Pump Inhibitor deprescribing algorithm
- Click here to evaluate the video if you are a health care provider or front-line health care staff
- Click here to evaluate the video if you are a patient or health care consumer
- Click here to evaluate the video if you are a family caregiver (e.g. child, spouse)

Antihyperglycemic

Antihyperglycemics are a class of drugs used to treat diabetes. They work in a variety of ways to lower blood sugar.

Antihyperglycemic deprescribing guideline (published in Canadian Family Physician)
Antihyperglycemic deprescribing algorithm
Antihyperglycemic deprescribing guideline information pamphlet
Antihyperglycemic deprescribing infographic
Whiteboard video on using the Antihyperglycemic deprescribing algorithm
- Click here to evaluate the video if you are a health care provider or front-line health care staff
- Click here to evaluate the video if you are a patient of health care consumer
- Click here to evaluate the video if you are a family caregiver (e.g. child, spouse)

Antipsychotic

Antipsychotics are a class of drugs sometimes used for behavioural and psychological symptoms of dementia and insomnia. They are primarily used to treat psychiatric disorders such as bipolar disorder and schizophrenia, among other disorders. Antipsychotics affect a variety of neurotransmitters in the brain. This results in a calming, relaxing effect, but can also produce sedation and affect balance.

Antipsychotic deprescribing guideline (published in Canadian Family Physician)
Antipsychotic deprescribing algorithm
Antipsychotic deprescribing guideline information pamphlet
Antipsychotic deprescribing infographic
Whiteboard video on using the Antipsychotic Deprescribing Algorithm
- Click here to evaluate the video if you are a health care provider or front-line health care staff
- Click here to evaluate the video if you are a patient or health care consumer
- Click here to evaluate the video if you are a family caregiver (e.g. child, spouse)

Benzodiazepine Receptor Agonist (BZRA)

Benzodiazepine receptor agonists are a class of drugs also called hypnotics or sedatives that are commonly prescribed for insomnia, among other conditions. They appear to work by suppressing the activity of nerves. This results in a calming, relaxing effect but can also produce sedation and affect memory.

Benzodiazepine Receptor Agonist deprescribing guideline (published in Canadian Family Physician)
Benzodiazepine Receptor Agonist deprescribing algorithm
Benzodiazepine and Z-Drug deprescribing guideline information pamphlet
Benzodiazepine and Z-Drug deprescribing infographic
Whiteboard video on using the Benzodiazepine Receptor Agonist deprescribing algorithm
- Click here to evaluate the video if you are a health care provider or front-line health care staff
- Click here to evaluate the video if you are a family caregiver (e.g. child, spouse)
- Click here to evaluate the video if you are a patient or health care consumer

Cholinesterase Inhibitors (ChEIs) and Memantine

Cholinesterase inhibitors and memantine are drugs used to treat the symptoms of dementia.

Cholinesterase Inhibitors and Memantine deprescribing guidelines (published with the University of Sydney)
Cholinesterase Inhibitors and Memantine deprescribing algorithm
Whiteboard video on using the Acetylcholinesterase/memantine deprescribing algorithm

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. Contact [email protected] for more information.

Developing an Evidence-based Deprescribing Guideline: Instruction Manual for Guideline Coordinators

The purpose of this manual is to provide step-by-step instructions for developing a medication class specific evidence-based deprescribing guideline. This manual is for individuals coordinating the development of such guidelines, as well as those who require an estimate of the workload, activities and time involved in such development to establish accurate timelines and budgets. Download the PDF manual here.

Translation and adaptations

Interested in translating the algorithms into other languages? Please read our translations policy here.

Want to adapt the algorithms to meet standards and guidelines of your health care setting? Please read our modification policy here.

To inquire about commercial licensing, (i.e. using the Bruyère Deprescribing Guidelines Research Team’s materials in textbooks, booklets, packages, etc. that are intended to be sold for profit) please email [email protected].