ArticleJournal of the American Geriatrics Society2025
Defining key deprescribing measures from electronic health data: A multisite data harmonization project.
Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effect of down-titration and discontinuation of heart failure pharmacotherapy in older people: A systematic review and meta-analysis.British journal of clinical pharmacology · 2025Pooled it
- Trial
- Integrating patient education on deprescribing into care delivery: Learnings from the Optimize pragmatic trial.Patient education and counseling · 2026Trial
- Comparing Fourteen Behavioral Science Electronic Health Record Deprescribing Tools in Older Adults: NUDGE-EHR Adaptive Trial.Journal of the American Geriatrics Society · 2025Trial
- Real-world treatment courses after anti-TNF de-escalation in older adults with rheumatoid arthritis: a medicare cohort study.BMC rheumatology · 2026Article
- Sociodemographic differences in discontinuation of high-risk medications: a retrospective cohort study.npj aging · 2025Article
- Discontinuing Chronic Medications Suggested for Deprescribing in Routine Clinical Practice: Nationwide Evidence From Routinely Collected Data in Swedish Older Adults.Basic & clinical pharmacology & toxicology · 2025Article
- The US Deprescribing Research Network: a network to catalyze deprescribing science.Frontiers in medicine · 2025Article
- The U.S. deprescribing research network: Catalyzing research and action to optimize medication use in older adults.Journal of the American Geriatrics Society · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
backgroundStopping or reducing risky or unneeded medications ("deprescribing") could improve older adults' health. Electronic health data can support observational and intervention studies of deprescribing, but there are no standardized measures for key variables, and healthcare systems have differing data types and availability. We developed definitions for chronic medication use and discontinuation based on electronic health data and applied them in a case study of benzodiazepines and Z-drugs in five diverse US healthcare systems.
methodsWe conducted a retrospective cohort study of adults age 65+ from 2017 to 2019 with chronic benzodiazepine or Z-drug use. We determined whether sites had access to medication orders and/or dispensings. We developed definitions for chronic use and discontinuation using both data types. Discontinuation definitions were based on (1) gaps in medication availability during follow-up or (2) not having medication available at a fixed time point. We examined the impact of varying the gap length and requiring a 30-day period without orders/dispensings ("halo") around the fixed time point. We compared results derived from orders versus dispensings at one site.
resultsApproximately 1.6%-2.6% of older adults had chronic benzodiazepine/Z-drug use (total N = 6775, ranging from 431 to 2122 across sites). Depending on the definition and site, the proportion discontinuing use during 12 months ranged from 6% to 49%. Requiring a longer gap or a 30-day "halo" resulted in lower estimates. At one site, only 56% of those with chronic use defined from orders also qualified based on dispensings, and the discontinuation rate at 180 days was 20% from orders versus 32% from dispensings.
conclusionsRequiring a gap of ≥90 days or a "halo" around a time point may more accurately capture discontinuation than using a shorter gap or no halo. Orders data underestimate discontinuation compared to dispensings. Work is needed to adapt these definitions for other drug classes and settings.
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Registered trials
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.