Ten deprescribing articles you should know about: A guide for newcomers to the field

Deprescribing is the planned and supervised process of stopping a medication when that medication may no longer be necessary, is causing more harm than good or does not align with a person's healthcare goals and treatment preferences. There has been an explosion of deprescribing research published over the last 10 years. Researchers in the field have been doing everything from evaluating deprescribing rates in usual care to studying barriers and facilitators around establishing deprescribing in routine clinical practice. More recently, interventions specifically designed to intervene on major determinants of deprescribing have been developed and tested. For someone new to the field (e.g., researchers new to the field, trainees or clinicians interested in learning more about deprescribing research), it might be difficult to know where to begin in order to gain a solid grasp of the deprescribing literature. At the 1st International Conference on Deprescribing, held in Denmark in September 2022, this author group discussed which deprescribing articles represented work that collectively provides a diverse overview of the field for newcomers. We hoped such a collection of articles would provide an overview of the breadth of work in this area and highlight seminal pieces that shaped the field. We were inspired by the success of similar lists in related fields1 and previous discussions on social media. Our group of deprescribing experts (n = 8) first generated a preliminary list of 31 possible articles, from which we aimed to narrow down to a final 10. We tasked ourselves with thinking about articles that covered a broad range of topics in the field and articles that had the following characteristics: high impact on the field, high-level articles (such as reviews, which could provide broad overview of research on a specific topic) or studies that incorporated novel approaches. Once we generated a preliminary list, we sent out a survey asking the eight authors “Should this article be in the Top 10?” for the 31 candidate articles. We tallied the “Yes” votes, and the 10 articles with the most “Yes” votes were included in the final list (Table 1). We created the following categories to group the articles under after the 10 were identified: “Critical concepts,” “High level overviews,” “Major trials,” “The complexity of deprescribing” and “Knowledge synthesis in deprescribing.” There are some articles that did not make the Top 10 that some of us still felt strongly were useful for newcomers to know about. These articles offer additional insight into important concepts in the field such as design of deprescribing interventions,2 countering cognitive biases related to deprescribing3 and the consequences of polypharmacy.4 Newcomers may also want to be aware of landmark trials that have tested novel deprescribing concepts or interventions,5-7 as well as the recent focus on implementation science in the field of deprescribing,8 and the influence of health system factors on deprescribing implementation and success.9 We recognize that this list is not exhaustive by any means and is based on the opinions of a group of established researchers in the field. It is not a comprehensive list of all the important deprescribing articles. However, it provides a start-up kit for newcomers wondering “where to start.”</p