The art and science of deprescribing: A practical guide for nurse practitioners

Inappropriate polypharmacy is a critical threat to patient safety, contributing to adverse drug events, falls, and diminished quality of life. Although an essential clinical intervention, deprescribing remains underused due to clinician-specific and systemic barriers. This article explores deprescribing as both an art and a science, providing a structured five-step clinical framework tailored for nurse practitioners. Two case scenarios, involving a 50-year-old woman transitioning to hospice and a 74-year-old man in primary care, illustrate how to implement comprehensive medication reviews, use tools like the Beers Criteria, realign therapeutic goals, and safely substitute high-risk agents. By synthesizing pharmacological science with shared decision making, nurse practitioners can successfully mitigate patient anxiety, overcome resource barriers, and normalize deprescribing as a standard of holistic, patient-centered care.