One in 6 Deprescribed Medications Are Restarted Within 90 Days

In an exploration of thousands of drugs deprescribed among patients in a hospital setting, 1 in 6 of the medications deprescribed were later restarted within 90 days, according to a study in JAMA Network Open.¹

“Deprescribing is the planned and supervised process of reducing or stopping medications that might be causing harm or are no longer benefiting the patient,” wrote authors of a study in Exploratory Research in Clinical and Social Pharmacy.² “While several definitions for deprescribing exist, they each entail identifying medications that may no longer be appropriate for a patient and working with the patient and health care team to develop a plan to reduce the dose of that medication or stop it altogether.”

The study, which pooled data from 2 randomized trials involving 598 participants, found that nearly 70% of patients restarted at least 1 medication. The overall durability, however, of deprescribing remained high, with 84% of all discontinued drugs staying stopped at the 90-day mark.¹

Researchers noted that restarts were most frequent during the transition from skilled nursing facilities (SNFs) back to the home environment, with nearly half of all restart episodes occurring between the 1-week and 90-day follow-up points. This timing is critical for pharmacists to monitor, as the daily restart rate was found to be at its highest during the very first week a patient returns home.

Medication restarts occurring during the SNF stay were associated with higher 90-day hospital readmission rates, suggesting that these reversals may serve as markers for clinical instability or fragmented care plans.¹

READ MORE: Pharmacists Need Greater Support for Deprescribing Services

For pharmacists, these findings underscore the high-risk nature of care transitions, where communication lapses and incomplete documentation often lead to medication errors or unnecessary therapeutic reversals. As medication experts, pharmacists are uniquely positioned to serve as a link between providers and patients, ensuring that the clinical rationale for stopping a drug in the hospital is effectively communicated to the next care team.^2,3

Systemic vulnerabilities, such as care fragmentation involving multiple prescribers, were identified as major drivers of medication restarts. The data show that patients seen by a higher number of outpatient prescribers were at a greater risk of restarts, highlighting the need for pharmacists to facilitate interdisciplinary collaboration and clear role clarity among the health care team.^1,4

Patient-specific elements like health literacy also played a protective role, with individuals who had higher health literacy scores being significantly less likely to experience a medication restart. This suggests that pharmacists can have a measurable impact by providing tailored medication education that helps patients and caregivers understand the risks and benefits of their therapy.^1,3-5

Specifically, pharmacist-led programs like Synchrony’s ArrivalRX and Rx@HOME demonstrate how early intervention and post-discharge follow-up calls can bridge the transition gap. These remedies can ensure patients have essential medications while identifying potential issues like side effects or instruction confusion early on.³

The most common classes of drugs to be restarted included nonopioid analgesics, antihypertensives, and diabetes medications, often because of recurring symptoms or the perceived need to return to a baseline established before the hospital stay.¹

However, polypharmacy, the use of 5 or more medications, remains a major driver of falls, adverse drug reactions, and functional decline in geriatric populations, making the pharmacist’s role in maintaining deprescribing essential for long-term safety.⁵

Despite the clear benefits, pharmacists face significant barriers to successful deprescribing, including a lack of financial incentives and limited access to shared electronic health records. Qualitative evidence indicates that many pharmacists view deprescribing as a professional responsibility, yet they are often pressured by competing priorities like medication reconciliation and missed doses.^2,4

To address these challenges, experts recommend expanding the pharmacist’s scope of practice to include independent deprescribing authority and integrating more robust training and simulations into pharmacy school curricula.

By serving as leaders in the interdisciplinary team, pharmacists can help reduce the "additive bias" often seen in hospital settings, where medications are frequently added but rarely removed. This transition toward value-based care suggests that the role of pharmacists in transitions of care should no longer be optional but rather an expected standard for patient safety.^2,3

“In this cohort study, medication restart after hospital-initiated deprescribing was common, especially after the SNF-to-home transition, and was associated with patient and system factors,” concluded the authors of the current study.¹ “In the context of prior trial findings and the broader deprescribing literature, these results suggest that effective deprescribing requires not only safe in-hospital medication reduction but also deliberate strategies to sustain those changes across care transitions and clinical settings, with focused support for patients at highest risk of restart.”

READ MORE: Deprescribing Leads to Reduction in Polypharmacy, Inappropriate Medication Use

REFERENCES

1. Reese TJ, Simmons SF, Vasilevskis EE, et al. Restarting medications after deprescribing in adults discharged from hospital to skilled nursing. JAMA Netw Open. 2026;9(6):e2617264. doi:10.1001/jamanetworkopen.2026.17264

2. Cernasev A, Scott D, Eckert B, et al. The role of U.S. pharmacists in deprescribing: recommendations based on a systematic literature review of qualitative studies. Explor Res Clin Soc Pharm. 2025 Jun 24;19:100625. doi: 10.1016/j.rcsop.2025.100625

3. Seay M. Bridging the gap: how pharmacists strengthen transitions of care. American Association of Post-Acute Care Nursing. September 9, 2025. Accessed July 30, 2026. https://www.aapacn.org/solution-providers/bridging-the-gap-how-pharmacists-strengthen-transitions-of-care/

4. Bolt J, Khattra P, Chiu D, et al. Pharmacists’ barriers and enablers to deprescribing: a systematic review and meta-synthesis. Res Soc Adm Pharm. 2026;22(4):561-573. doi:10.1016/j.sapharm.2026.01.006

5. Ngcobo NN. Polypharmacy and deprescribing among geriatric patients. Aging Health Res. 2025;5(3):100256. doi:10.1016/j.ahr.2025.100256