Polypharmacy, defined as the use of 5 or more medications, is becoming increasingly common in older adults, internationally. For example, in a Canadian survey of experiences with primary health care, 27% of older adults reported taking 5 or more medications on a regular basis.1 Polypharmacy is associated with medication-related adverse effects such as frailty, disability, death, and falls.2 Deprescribing—the process of withdrawing an inappropriate medication, under the supervision of a health care professional, with the goal of managing polypharmacy and improving outcomes—may be a solution to reduce the harm associated with using multiple medications.3 Evidence is accumulating to suggest that initiating deprescribing interventions within the hospital setting can be feasible, safe, and sustained after discharge. For patients with polypharmacy, admission to hospital can give clinicians an opportunity to reassess medications, identify the risks and harms of the current medication regimen, and initiate deprescribing of inappropriate medications, because the necessary resources, time, and specialist health care practitioners are often readily available in this setting. Hospitals also represent a somewhat “controlled” environment, where clinicians can closely monitor and reassess patients after implementing deprescribing interventions. To evaluate whether hospitalization should be used as an opportunity for deprescribing, the effectiveness of hospital-based deprescribing interventions must be analyzed.
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