The Nurse as Catalyst: Investigating and Expanding the Role of Nursing within a Deprescribing Model with Physicians and Pharmacists of General Medicine

Background: Polypharmacy is widespread among older adults and individuals with chronic conditions and increases the risks of adverse drug events, hospitalizations, and mortality. Deprescribing, the systematic reduction of medications that are unnecessary or potentially inappropriate (PIMs), can help mitigate these risks. Although nurses are well-suited to do deprescribing because of frequent patient interactions and a holistic lens to the overall patient, the role of the nurse in deprescribing remains underexplored. Aim: The purpose of this review is to explore the role of nurses in deprescribing in general medicine and to examine their involvement along with physicians and pharmacists. The paper identifies barriers and facilitators to involvement and pathways forward. Methods: We conducted a narrative review focused on peer-reviewed studies from 2020-2024 using PubMed, CINAHL, Scopus, and Web of Science. We used variations of the search terms "deprescribing", "nursing," and "polypharmacy." The inclusion criteria were English-language, peer-reviewed studies that focused on nurse-led deprescribing within the general medicine scope. We extracted data on nurse role, patient outcomes, and barriers/facilitators relevant to the study, using inductive thematic analysis. Results: Nurses were found to contribute through patient assessment, education, advocacy, and interdisciplinary care, reducing PIMs by as much as 30% and ADEs by 20%. Barriers included a lack of authority and a lack of time, and factors that facilitated successful nursing involvement included previous training in deprescribing methodology and integration of the Educator role with Electronic Health Records (EHR) nursing documentation. Conclusion: Nurses must play a central role in the process of deprescribing (to improve patient safety). Policy changes, nurse education, and technology will assist in embedding the nursing profession into deprescribing initiatives. Future research must focus on the use of a diverse range of settings, with longer-term follow-up outcomes.