Evidence mapPaperPMID 37438697Full record

SynthesisBMC geriatrics2023

Outcomes in deprescribing implementation trials and compliance with expert recommendations: a systematic review.

Pierre Nizet, Adrien Evin, Emma Brociero, Caroline Victorri Vigneau, Jean-François Huon

Abstract readSystematic Review
In one paragraph

Synthesis in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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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.

Pierre NizetNantes Université, CHU Nantes, 44000, Pharmacie, France. pierre.nizet@chu-nantes.fr.ORCID 0000-0001-6912-0025
Adrien EvinNantes Université, CHU Nantes, Service de Soins Palliatifs Et de Support, 44000, Nantes, France.ORCID 0000-0002-5720-1597
Emma BrocieroNantes Université, CHU Nantes, 44000, Pharmacie, France.
Caroline Victorri VigneauU1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Université de Nantes, Université de Tours, INSERM, Nantes, France.
Jean-François HuonNantes Université, CHU Nantes, 44000, Pharmacie, France.ORCID 0000-0002-8738-4419

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeprescribing, defined as discontinuing or reducing the dose of medications that are no longer needed or for which the risks outweigh the benefits is a way to reduce polypharmacy. In 2022, the US Deprescribing Research Network (USDeN) published recommendations concerning the measurement of outcomes for deprescribing intervention studies. The objectives of this systematic review were to identify the outcome categories used in deprescribing intervention trials and to relate them to the previously published recommendations.

methodsWe searched MEDLINE, Embase, PsychInfo, and the Cochrane library from January 2012 through January 2022. Studies were included if they were randomized controlled trials evaluating a deprescribing intervention. After data extraction, outcomes were categorized by type: medication outcomes, clinical outcomes, system outcomes, implementation outcomes, and other outcomes based on the previously published recommendations.

resultsThirty-six studies were included. The majority of studies focused on older adults in nursing homes and targeted inappropriate medications or polypharmacy. In 20 studies, the intervention was a medication review; in seven studies, the intervention was educational or informative; and three studies based their intervention on motivational interviewing or patient empowerment. Thirty-one studies presented a medication outcome (primary outcome in 26 studies), 25 a clinical outcome, 18 a system outcome, and seven an implementation outcome. Only three studies presented all four types of outcomes, and 10 studies presented three types of outcomes.

conclusionsThis review provides an update on the implementation of gold standard deprescribing studies in clinical practice. Implementation outcomes need to be developed and specified to facilitate the implementation of these practices on a larger scale and clinical outcome need to be prioritized. Finally, this review provides new elements for future real-life deprescribing studies.

Indexed as

DeprescriptionsMedication AdherenceAgedEducational StatusHumansMedication ReviewNursing HomesPatient ComplianceDeprescribingOutcome assessmentPolypharmacyPotentially inappropriate medicationsReview

Identifiers

PMID37438697
PMCPMC10337166

What Socratic holds

Textmetadata
LicenceCC BY
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.