Establishing the worth of deprescribing inappropriate medications: are we there yet?

The burden and costs of potentially inappropriate medications (PIMs) and polypharmacy are major public health challenges. Medicines that are ineffective or no longer indicated, discordant with care goals or where harms outweigh benefits should be deprescribed.1 However, despite the publication of numerous deprescribing studies and guidelines over the past decade, the effectiveness of deprescribing interventions in routine care remains unclear. In this Perspective, we describe the impacts of deprescribing on clinical outcomes, draw insights from recent trials, and discuss opportunities for designing future trials better able to demonstrate the patient-important effects of deprescribing.