We know many people end up with a risky pileup of prescribed medications. Many efforts have been made, with varied success, to correct this problem. Yet we’ve usually focused on physician behavior, when there’s another powerful lever: pharmacists.

About 30 percent of older adults in the United States and Canada filled a prescription in the last few years for one of many medications that the American Geriatrics Society recommends they avoid. Such drugs can lead to more harm — like cognitive impairment or falls — than good, and often safer options are available.

“Older adults are taking an awful lot of pills these days — 66 percent take five drugs or more per day, and 27 percent take 10 or more per day — so if some of those pills are no longer necessary and may even be causing harm, why not ask if it is time to deprescribe?” said Dr. Cara Tannenbaum, a professor of medicine and pharmacy at the University of Montreal, and director of the Canadian Deprescribing Network.

It’s not easy to get patients off such drugs, though. Physicians often don’t have enough information about what patients are taking, or may lack the time to talk to patients about these medications. They fear that stopping the drugs might cause harm or make patients upset.