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Table 2 Deprescribing Rationales

From: A patient-centered deprescribing intervention for hospitalized older patients with polypharmacy: rationale and design of the Shed-MEDS randomized controlled trial

A. No indication for medication / Indication not clear B. Absolute contraindication C. Wrong dose or directions for medication D. Inappropriate for current indication due to: 1. Indication has resolved 2. Patient is below treatment threshold 3. Treating guidelines have changed, medication no longer indicated 4. Wrong indication for medication E. Medication is ineffective as evidenced by no change in symptom or condition F. Duplicate medication for same indication G. High risk medication based on: 1. Potential drug-drug interaction 2. Potential drug-disease interaction (e.g. associated with geriatric syndrome) 3. On explicit list of PIMs (Beer’s, STOPP and/or RASP) H. Medications are inconsistent with goals of care H. Risk > benefit given patients limited life expectancy I. Evidence of poor adherence or high risk of poor adherence (directions impractical, high cost) J. Medication currently indicated, but is time-limited and indication expected to resolve