Evidence map›Paper›PMID 30249607›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2018

Effects of discontinuation of chronic medication in primary care: a systematic review of deprescribing trials.

Sioe Lie Thio, Joana Nam, Mieke L van Driel, Thomas Dirven, Jeanet W Blom

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  6. Ambulatory Medication Safety in Primary Care: A Systematic Review.Journal of the American Board of Family Medicine : JABFM
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sioe Lie ThioDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Joana NamPrimary Care Clinical Unit, Faculty of Medicine, the University of Queensland, Brisbane, Australia.
Mieke L van DrielPrimary Care Clinical Unit, Faculty of Medicine, the University of Queensland, Brisbane, Australia.
Thomas DirvenDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Jeanet W BlomDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolypharmacy is becoming more prevalent and evaluation of appropriateness of medication use is increasingly important. The primary care physician often conducts the deprescribing process; however, there are several barriers to implementing this.

aimTo examine the feasibility and safety of discontinuation of medication, with a focus on studies that have been conducted in the community, that is, primary care (or general practice) and nursing homes. DESIGN AND

settingThis systematic review included randomised controlled trials published in 2005-2017, which studied withdrawal of long-term drugs prescribed in primary care settings and compared continuing medication with discontinuing.

methodPubMed and EMBASE searches were conducted and the extracted data included the number of patients who successfully stopped medication and the number of patients who experienced relapse of symptoms or restarted medication.

resultsA total of 27 studies reported in 26 papers were included in this review. The number of participants in the studies varied from 20 to 2471 and the mean age of participants ranged from 50.3 years to 89.2 years. The proportion of patients who successfully stopped their medication varied from 20% to 100%, and the range of reported relapse varied from 1.9% to 80%.

conclusionOnly a few studies have examined the success rate and safety of discontinuing medication in primary care, and these studies are very heterogeneous. Most studies show that deprescribing and cessation of long-term use seem safe; however, there is a risk of relapse of symptoms. More research is needed to advise physicians in making evidence-based decisions about deprescribing in primary care settings.

Indexed as

Nursing HomesPrimary Health CareDeprescriptionsHumansInappropriate PrescribingPolypharmacyRandomized Controlled Trials as Topicdeprescribinggeneral practicemedication discontinuationprimary caresystematic review

Identifiers

PMID30249607
PMCPMC6145971

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.