to help people who are struggling with polypharmacy is deprescribing. deprescribing can be confused with medication simplification, which does not attempt to reduce the number of medicines but rather reduce the number of dose forms and administration times. deprescribing refers to reducing the number of medications that a person is prescribed and includes the identification and discontinuance of medications when the benefit no longer outweighs the harm. in elderly patients, this can commonly be done as a patient becomes more frail and treatment focus needs to shift from preventative to palliative. deprescribing is feasible and effective in many settings including residential care, communities and hospitals. this preventative measure should be considered for anyone who exhibits one of the following: (1) a new symptom or adverse event arises, (2) when the person develops an end-stage disease, (3) if the combination of drugs is risky, or (4) if stopping the drug does not alter the disease trajectory. several tools exist to help physicians decide when to deprescribe and what medications can be added to a pharmaceutical regimen. the beers criteria and the stopp/start criteria help identify medications that have the highest risk of adverse drug events (ade) and drug-drug interactions. the medication appropriateness tool for comorbid health conditions during dementia (match-d) is the only tool available specifically for people with dementia, and also cautions against polypharmacy and complex medication regimens. barriers faced by both physicians and people taking the medications have made it challenging to apply deprescribing strategies in practice. for physicians, these include fear of consequences of deprescribing, the prescriber's own confidence in their skills and knowledge to deprescribe, reluctance to alter medications that are prescribed by specialists, the feasibility of deprescribing, lack of access to all of patients' clinical notes, and the complexity of having multiple providers. for patients who are prescribed or require the medication, barriers include attitudes or beliefs about the medications, inability to communicate with physicians, fears and uncertainties surrounding deprescribing, and influence of physicians, family, and the media. barriers can include other health professionals or carers, such as in residential care, believing that the medicines are required. the effectiveness of specific interventions to improve the appropriate use of polypharmacy such as pharmaceutical care and computerised decision support is unclear. this is due to low quality of current evidence surrounding these interventions. high quality evidence is needed to make any conclusions about the effects of such interventions in any environment, including in care homes. deprescribing is not influenced by whether medicines are prescribed through a paper-based or an electronic system. deprescribing rounds has been proposed as a potentially successful methodology in reducing polypharmacy. sharing of positive outcomes from physicians who have implemented deprescribing, increased communication between all practitioners involved in patient care, higher compensation for time spent deprescribing, and clear deprescribing guidelines can help enable the practice of deprescribing. despite the difficulties, a recent blinded study of deprescribing reported that participants used an average of two fewer medicines each after 12 months showing again that deprescribing is feasible.