Researchers at McGill University have developed a digital tool designed to help patients safely reduce their use of medications that may be unnecessary or even harmful. The software, called MedSafer, is now being licensed for broader use and has already demonstrated strong results in clinical settings. By guiding clinicians through a patient’s medication list, the tool helps identify drugs that may no longer be appropriate and provides recommendations on how to taper or stop them safely.
In a recent clinical trial, MedSafer proved to be nearly three times more effective than standard medication reviews. Among residents in long-term care facilities, 36 per cent had potentially harmful medications discontinued with the support of the software, compared with far lower rates when clinicians worked without it. “Sometimes we blame ageing for memory loss or mobility issues when the real culprit is the medications,” explained Dr Emily McDonald, Associate Professor in McGill’s Department of Medicine and Scientist at the Research Institute of the McGill University Health Centre. “I’ve seen patients go from barely responsive to having full conversations again after stopping a sedating drug.”
The issue of polypharmacy—taking multiple medications at once—is especially pressing among older adults. Nearly two-thirds of Canadian seniors are prescribed five or more medications each day, with numbers even higher in long-term care settings. Over time, prescriptions tend to accumulate, and some are even added to manage the side effects of other drugs, creating what experts call a “prescribing cascade.” This cycle not only complicates treatment but also increases the risk of dangerous side effects, such as falls, confusion, and hospitalisations.
MedSafer is intended to provide a practical solution within routine care. In long-term care homes, medications are typically reviewed every three months, but there is no consistent framework for deprescribing. The software acts as a structured checklist for clinicians, comparing a resident’s prescriptions with their health conditions, flagging potential concerns, and offering evidence-based alternatives. In the New Brunswick trial, which involved 725 residents across five facilities, participants were taking an average of ten different medications each, highlighting the scale of the challenge.
The tool was co-developed by Dr McDonald and Dr Todd Lee, Associate Professor of Medicine at McGill and fellow Scientist at the Research Institute. Both stress that the long-term goal is to see MedSafer integrated into primary care, where it could intervene earlier in a patient’s treatment journey. By identifying and discontinuing unnecessary prescriptions before individuals enter long-term care, the tool has the potential to reduce medication-related harm on a much broader scale.
For McDonald and Lee, the promise of MedSafer lies in transforming deprescribing into a new standard of care. “No one should be on a medication that’s doing more harm than good,” said Dr McDonald. With growing evidence of its effectiveness, the researchers hope their tool will help shift clinical practice towards a safer, more personalised approach to prescribing, improving not only patient health but also quality of life for countless older adults.
More information: Emily McDonald et al, Electronic Decision Support for Deprescribing in Older Adults Living in Long-Term Care, A Stepped-Wedge Cluster Randomized Trial, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.12931
Journal information: JAMA Network Open Provided by McGill University
