Overviews of polypharmacy:
Kwan D, Farrell B. Polypharmacy: Optimizing medication use in elderly patients. Pharmacy Practice 2013;Apr/May:20-25.
Hilmer SN, Gnjidic D. The effects of polypharmacy in older adults. Clin Pharmacol Ther 2009;85(1):86-8 doi: 10.1038/clpt.2008.224.
Scott IA, Anderson K, Freeman CR, et al. First do no harm: a real need to deprescribe in older patients. Med J Aust 2014;201(7):390-2.
Zelmer J. De-prescribing: When less is more in healthcare. Healthcare Policy 2016;11(3):6-9.
General approaches and algorithms to help with deprescribing decisions:
Bain KT, Holmes HM, Beers MH, Maio V, Handler SM, Pauker SG. Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process. J Am Geriatr Soc. 2008;56(10):1946-52.
Hardy JE, Hilmer SN. Deprescribing in the last year of life. J Pharm Pract Res 2011;41:146-151.
Lemay G, Daziel B. Better prescribing in the elderly. Can Geriatrics Society Journal of CME 2012; 2(3);20-26.
Case reports on polypharmacy management that give examples of deprescribing (from the Bruyere Continuing Care Geriatric Day Hospital in Ottawa, Canada)
Commentaries about the case reports (intro to the series)
Farrell B, Shamji S, Monahan A, French Merkley V. Clinical vignettes to help you deprescribe medications in elderly patients: introduction to the polypharmacy case series. Canadian Family Physician 2013;59:1257-1258.
Farrell B, Shamji S, Monahan A, French Merkley V. Reducing polypharmacy in the elderly: Cases to help you rock the boat. Canadian Pharmacists Journal 2013;146(5):243-244.
Farrell B, Eisener-Parsche P, Dalton D. Turning over the rocks – the role of anticholinergics and benzodiazepines in cognitive decline and falls. Canadian Family Physician 2014;60:345-350.
Farrell B, French Merkley V, Ingar N. Reducing pill burden and helping with medication awareness to improve adherence. Canadian Pharmacists Journal 2013;146(5):262-269.
Farrell B, French Merkley, Thompson W. Managing polypharmacy in a 77-year-old woman with multiple prescribers. CMAJ 2013;185:1240-1245.
Farrell B, Monahan A, Thompson W. Revisiting ongoing medication use in a frail 93 year old experiencing possible adverse effects. Canadian Medical Association Journal 2014;186:445-449. doi:10.1503/cmaj.130523.
Farrell B, Shamji S, Dalton D. Managing chronic disease in the frail elderly – more than just adhering to clinical guidelines. Canadian Pharmacists Journal 2014;147(2):89-96.
Farrell B, Monahan A, Ingar N. Identifying and managing drug-related causes of common geriatric symptoms. Canadian Family Physician 2014;60:147-153.
Farrell B, Shamji S, Ingar N. Reducing fall risk while managing hypotension, pain and poor sleep in an 83 year old woman. Canadian Family Physician 2013;59:1300-1305.
Farrell B, Shamji S, Ingar N. Reducing fall risk while managing pain and insomnia: addressing polypharmacy in an 81 year old woman. Canadian Pharmacists Journal 2013;146(6):335-341.
Summaries of patient and physician challenges and enablers to deprescribing
Anderson K, Stowasser D, Freeman C, Scott I. Prescriber barriers and enablers to minimizing potentially inappropriate medications in adults: a systematic review and thematic synthesis. BMJ Open 2014;4:e006544 doi: 10.1136/bmjopen-2014-006544
Reeve E, To E, Hendrix I, Shakib S, Roberts MS, Wiese MD. Patient barriers to and enablers of deprescribing: a systematic review. Drugs Aging 2013;30(10):793-807.
Reeve E, Shakib S, Hendrix I, et al. The benefits and harms of deprescribing. Med J Aust 2014;201(7):386-9
Schuling J, Gebben H, Veehof LJ, Haaijer-Ruskamp FM. Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study. BMC Fam Pract. 2012;13:56.
Turner J, Edwards S, Stanners M, Shakib S, Bell JS. What factors are important for deprescribing in Australian long-term care facilities? Perspectives of residents and health professionals. BMJ Open 2016;6:e009781 doi:10.1136.
Monitoring for adverse drug withdrawal events
Graves T, Hanlon JT, Schmader KE et al. Adverse events after discontinuing medications in elderly outpatients. Arch Intern Med 1997;157:2205-10.
Bain KT, Holmes HM, Beers M et al. Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process. J Am Geriatr Soc 2008;56:1946-52.
Publications about recent research that may help with deprescribing
Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of Inappropriate Benzodiazepine Prescriptions Among Older Adults Through Direct Patient Education: The EMPOWER Cluster Randomized Trial. JAMA Intern Med. 2014; 174(6):890-898.