Effectiveness of Patient-Directed Education to Sustain Deprescribing: A Pragmatic Trial

Bala SS, Chen TF, Nishtala PS. Reducing potentially inappropriate medications in older adults: a way forward. Can J Aging. 2019;38(4):419–33.

PubMed  Google Scholar 

Tian F, et al. Prevalence of use of potentially inappropriate medications among older adults worldwide: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(8):e2326910–e2326910.

PubMed  PubMed Central  Google Scholar 

Veronese N, et al. Efficacy of deprescribing on health outcomes: an umbrella review of systematic reviews with meta-analysis of randomized controlled trials. Ageing Res Rev. 2024;95:102–237.

Google Scholar 

Sawan M, et al. A systems approach to identifying the challenges of implementing deprescribing in older adults across different health-care settings and countries: a narrative review. Expert Rev Clin Pharmacol. 2020;13(3):233–45.

PubMed  PubMed Central  CAS  Google Scholar 

Linsky A, Zimmerman KM. Provider and system-level barriers to deprescribing: interconnected problems and solutions. Public Policy Aging Rep. 2018;28(4):129–33.

Google Scholar 

Clayman ML, Elwy AR, Vassy JL. Reframing SDM using implementation science: SDM is the intervention. Med Decis Mak. 2024;44(8):859–61.

Google Scholar 

Ailabouni NJ, et al. Leveraging implementation science to increase the translation of deprescribing evidence into practice. Res Soc Adm Pharm. 2022;18(3):2550–5.

Google Scholar 

Curran GM. Implementation science made too simple: a teaching tool. Implement Sci Commun. 2020;1(1):27.

PubMed  PubMed Central  Google Scholar 

Reeve E. Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice. J Pharm Pract Res. 2020;50(1):98–107.

Google Scholar 

Alaa Eddine N, et al. A pharmacist-led medication review service with a deprescribing focus guided by implementation science. Front Pharmacol. 2023;14:1097238.

PubMed  PubMed Central  Google Scholar 

Scott IA, et al. Using EMR-enabled computerized decision support systems to reduce prescribing of potentially inappropriate medications: a narrative review. Ther Adv Drug Saf. 2018;9(9):559–73.

PubMed  PubMed Central  Google Scholar 

Crane ME, Purtle J, Becker SJ. Amplifying consumers as partners in dissemination and implementation science and practice. Implement Res Pract. 2023;4:26334895231205894.

PubMed  PubMed Central  Google Scholar 

Waltz TJ, et al. Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the expert recommendations for implementing change (ERIC) study. Implement Sci. 2015;10:109.

PubMed  PubMed Central  Google Scholar 

Powell BJ, et al. A refined compilation of implementation strategies: results from the expert recommendations for implementing change (ERIC) project. Implement Sci. 2015;10(1):21.

PubMed  PubMed Central  Google Scholar 

Burrows Walters C, Duthie EA. Patients’ perspectives of engagement as a safety strategy. Oncol Nurs Forum. 2017;44(6):712–8.

PubMed  Google Scholar 

Tannenbaum C, et al. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890–8.

PubMed  Google Scholar 

Proctor EK, et al. Ten years of implementation outcomes research: a scoping review. Implement Sci. 2023;18(1):31.

PubMed  PubMed Central  Google Scholar 

Bayliss EA, et al. Recommendations for outcome measurement for deprescribing intervention studies. J Am Geriatr Soc. 2022;70(9):2487–97.

PubMed  PubMed Central  Google Scholar 

Bolt J, Abdoulrezzak R, Inglis C. Barriers and enablers to deprescribing of older adults and their caregivers: a systematic review and meta-synthesis. Eur Geriatr Med. 2023;14(6):1211–22.

PubMed  Google Scholar 

Curran GM, et al. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217–26.

PubMed  PubMed Central  Google Scholar 

Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci. 2013;8:139.

PubMed  PubMed Central  Google Scholar 

Zwarenstein M, et al. Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337:a2390.

PubMed  PubMed Central  Google Scholar 

US Department of Veterans Affairs. VHA Corporate Data Warehouse. Updated 1 April 2024. https://www.hsrd.research.va.gov/for_researchers/cdw.cfm. Accessed 10 Jan 2025.

Martin P, et al. A drug education tool developed for older adults changes knowledge, beliefs and risk perceptions about inappropriate benzodiazepine prescriptions in the elderly. Patient Educ Couns. 2013;92(1):81–7.

PubMed  Google Scholar 

Martin P, et al. An educational intervention to reduce the use of potentially inappropriate medications among older adults (EMPOWER study): protocol for a cluster randomized trial. Trials. 2013;14(1):80.

PubMed  PubMed Central  Google Scholar 

US Department of Veterans Affairs. Whole Health. Published online 2025. https://www.va.gov/wholehealth/. Accessed 1 Apr 2025.

Shanika LGT, et al. Proton pump inhibitor use: systematic review of global trends and practices. Eur J Clin Pharmacol. 2023;79(9):1159–72.

PubMed  PubMed Central  CAS  Google Scholar 

Pauly NJ, et al. Trends in gabapentin prescribing in a commercially insured U.S. adult population, 2009–2016. J Manag Care Spec Pharm. 2020;26(3):246–52.

PubMed  Google Scholar 

Goodman CW, Brett AS. A clinical overview of off-label use of gabapentinoid drugs. JAMA Intern Med. 2019;179(5):695–701.

PubMed  Google Scholar 

Oktora MP, et al. Rates, determinants and success of implementing deprescribing in people with type 2 diabetes: a scoping review. Diabet Med. 2021;38(2):e14408.

PubMed  CAS  Google Scholar 

Cogan AM, et al. Provider discussion of health goals and psychosocial needs: comparing older to younger veteran experience. Health Serv Res. 2023;58(Suppl 1):9–15.

PubMed  Google Scholar 

Glasgow RE, et al. Re-aim planning and evaluation framework: adapting to new science and practice with a 20-year review. Front Public Health. 2019;7:64.

PubMed  PubMed Central  Google Scholar 

Jones KF, et al. Patient-directed education to promote deprescribing: a nonrandomized clinical trial. JAMA Intern Med. 2024;184(11):1339–46.

PubMed  PubMed Central  Google Scholar 

Sussman JB, et al. Rates of deintensification of blood pressure and glycemic medication treatment based on levels of control and life expectancy in older patients with diabetes mellitus. JAMA Intern Med. 2015;175(12):1942–9.

PubMed  PubMed Central  Google Scholar 

Lam KD, Miao Y, Steinman MA. Cumulative changes in the use of long-term medications: a measure of prescribing complexity. JAMA Intern Med. 2013;173(16):1546–7.

PubMed  PubMed Central  Google Scholar 

National Institute on Aging. NIA adverse event and serious adverse event guidelines. https://www.nia.nih.gov/sites/default/files/2018-09/nia-ae-and-sae-guidelines-2018.pdf. Accessed 1 Apr 2025.

Silva Almodóvar A, et al. Deprescribing medications among patients with multiple prescribers: a socioecological model. J Am Geriatr Soc. 2023. https://doi.org/10.1111/jgs.18667.

Article  PubMed  Google Scholar 

Turner JP, et al. Government direct-to-consumer education to reduce prescription opioid use: a cluster randomized clinical trial. JAMA Netw Open. 2024;7(5):e2413698–e2413698.

PubMed  PubMed Central  Google Scholar 

Anderson TS, et al. Older adult and primary care practitioner perspectives on using, prescribing, and deprescribing opioids for chronic pain. JAMA Netw Open. 2024;7(3):e241342–e241342.

PubMed  PubMed Central  Google Scholar 

Anderson TS. Educational brochures for deprescribing. JAMA Intern Med. 2024;184(11):1289. https://doi.org/10.1001/jamainternmed.2024.4755.

Article  PubMed  Google Scholar 

Mate K, et al. Evidence for the 4Ms: interactions and outcomes across the care continuum. J Aging Health. 2021;33(7–8):469–81.

PubMed  PubMed Central  Google Scholar 

Grant RW, et al. Diabetes deprescribing in older adults: a randomized clinical trial. JAMA Intern Med. 2025;185(8):926–35.

PubMed  Google Scholar 

Pendergast J, et al. Engaging patients in discussions about medication deprescribing. J Gen Intern Med. 2025;40(8):1811–9.

PubMed  Google Scholar 

Benthien KS, et al. Protocol for deprescribing and care to reduce antipsychotics in Dementia (DECADE)—a hybrid effectiveness-implementation pilot study. PLoS ONE. 2023;18(11):e0294024.

PubMed  PubMed Central  CAS 

Comments (0)

No login
gif