Importance: Older patients using many prescription drugs (hyperpolypharmacy) may be at increased risk of adverse drug effects.
Objective: To test the effectiveness and safety of a quality intervention intended to reduce hyperpolypharmacy.
Design, Setting, And Participants: This randomized clinical trial allocated patients 76 years or older who used 10 or more prescription medications to a deprescribing intervention or to usual care (1:1 ratio) at an integrated health system with multiple preexisting deprescribing workflows.