| Step | Consider | Resources |
|---|---|---|
| Identify potentially inappropriate medications | Continued necessity, benefit, contribution to or cause of an adverse reaction, future risk of adverse reaction, medication or food interactions, adherence, patient preference, goals of care, life expectancy | American Geriatrics Society Beers Criteria Anticholinergic burden scales Medstopper STOPP/START Criteria (screening tool of older persons' prescriptions) |
| Determine if the dosage can be reduced or the medication stopped Plan tapering and withdrawal steps Monitor (for adverse withdrawal events and against criteria for restarting) and support patient | How to best engage the patient in a conversation about deprescribing, determine options, and provide monitoring and support | Adverse medication withdrawal events information Deprescribing guidelines and algorithms Deprescribing information pamphlets Prescribing information (product monographs with information on dosing in older patients, renal dysfunction, or dosing and monitoring for discontinuation symptoms) Shared decision-making steps for deprescribing |
| Document outcomes | Documenting reasons for changes and positive and negative outcomes to facilitate future care and prescribing decision making | — |