Conclusion
A specialist outpatient clinic provides an additional setting to review for inappropriate medication use, especially for older patients who are often co-morbid and at significant risk of polypharmacy. Deprescribing for hospital inpatients may not be a focus during an acute admission, and in primary care general practitioners might be reluctant to cease medications prescribed elsewhere. A specialist outpatient clinic provides a setting for experts to appraise medical conditions that might change the risk-benefit profile of existing medications. While the evidence for deprescribing interventions in outpatient clinics is very limited, the addition of a pharmacist and use of validated medication assessment tools appear to be significant enablers. The most effective way to incorporate the deprescribing intervention has not been established and requires more research, but it might involve a multidisciplinary clinic that includes a pharmacist or a targeted pharmacist-led, physician-implemented intervention. It is also possible that the existence of a specific polypharmacy service could help to break the lack of intervention for patients with high medication burdens. Further research is recommended to confirm if this approach is effective, if the changes can be maintained, and if this approach translates to clinical benefit.