Medication Optimization
Summary / Key takeaways
Medications can be optimized during clinical medication reviews, where concerns and deprescribing opportunities can be identified (e.g., potential inappropriate medications, potential prescribing omissions, medications that are not dosed appropriately, address prescribing cascades).
Non-pharmacological strategies may represent a more environmentally friendly approach to care. Some of these strategies (e.g., social and nature prescribing) may already be employed at hospitals by healthcare professionals.
Examples include:
- using exercise therapy for pain
- dietary modifications
- exercise recommendations for hypertension
- addressing inpatient sleep disturbances
Implement a system of ongoing, criteria-based evaluation of medication use (i.e., Drug use evaluation (DUE) that will help ensure medications are being used appropriately within a healthcare setting.
Medicine stewardship programs are structured, often interprofessional programs, with the goal of improving quality use of medications and addressing challenges within a specific therapeutic specialty, ensuring appropriate and efficient use of resources. Stewardship teams and programs are particularly useful in improving medication use in specialties where there is a high risk of significant adverse effects and/or inappropriate prescribing.
Institutions can promote medication optimization by requiring healthcare providers to set a stop date for select medication orders to ensure the therapy is stopped when necessary.
Playbook: Medication Optimization for Sustainability in Inpatient Care
Suggested Citation:
Lam I, Fallis S, McCarthy L, Sergeant M. Medication Optimization for Sustainability in Inpatient Care. Version 1.0. [Internet]. CASCADES; 2024 [cited DATE]. Available from: https://new.cascadescanada.ca/.
Supporting Resources
Action Items for DUE Individuals and Teams
This checklist provides actions that drug use evaluation (DUE) individuals or teams can take to optimize the medication prescribed to patients to reduce the environmental, patient and institutional consequences of polypharmacy.
Checklist
Action Items for Institutional Healthcare Providers
This checklist provides actions that institutional healthcare providers can take to optimize the medication prescribed to patients to reduce the environmental, patient and institutional consequences of polypharmacy.
Checklist
Action Items for Institutional Management and Decision Makers
This checklist provides actions that institutional management and decision makers can take to optimize the medication prescribed to patients to reduce the environmental, patient and institutional consequences of polypharmacy.
Checklist
Common prescribing cascades
This resource provides examples of common prescribing cascades, which occur when a drug is prescribed to manage the side effects of another drug.
Document
Patient Handouts to support deprescribing
This table provides links to patient handouts, with the number of pages listed, that can be accessed to support deprescribing of specific medications.
Patient resource
Resource Tool Box
This tool box provides useful resources and tools that can be accessed to support medication optimization
Document






