Evidence mapPaperPMID 39847313Full record

Trial reportInternational journal of clinical pharmacy2025

Pharmacist-led deprescribing of cardiovascular and diabetes medication within a clinical medication review: the LeMON study (Less Medicines in Older Patients in the Netherlands), a cluster randomized controlled trial.

Jamila Abou, Petra J M Elders, Danielle Huijts, Rob van Marum, Jacqueline Hugtenburg

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in International journal of clinical pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Review
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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.

Jamila AbouDepartment of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centers, Location VUMC, Amsterdam, The Netherlands. j.abou@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-6521-6203
Petra J M EldersDepartment of General Practice, Amsterdam UMC, Location VU, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Danielle HuijtsDepartment of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centers, Location VUMC, Amsterdam, The Netherlands.
Rob van MarumDepartment of Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC (Location VUmc), Amsterdam, The Netherlands.
Jacqueline HugtenburgDepartment of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centers, Location VUMC, Amsterdam, The Netherlands.

Funding

Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2018-0387
6 · The paper itself

Abstract

backgroundDeprescribing inappropriate cardiovascular and antidiabetic medication has been shown to be feasible and safe. Healthcare providers often perceive the deprescribing of cardiovascular and antidiabetic medication as a challenge and therefore it is still not widely implemented in daily practice.

aimThe aim was to assess whether training focused on conducting a deprescribing-oriented clinical medication review (CMR) results in a reduction of the inappropriate use of cardiovascular and antidiabetic medicines.

methodA cluster randomized controlled trial involving 20 community pharmacists, who conducted a clinical medication review in 10 patients. The intervention group received training on deprescribing. Patients 70 years or older with polypharmacy having a systolic blood pressure below 140 mmHg and using antihypertensive medication and/or an HbA1c level below 54 mmol/mol and using antidiabetic medication, were included. Follow-up took place within 4 weeks (T1) and after 3 months (T2). The primary outcome measure was the proportion of patients with one or more cardiovascular and antidiabetic medicine deprescribed within 3 months after the CMR (T2).

resultsA total of 71 patients in the intervention group and 69 patients in the control group were included. At T2, 32% of patients in the intervention group and 26% in the control group (OR 1.4, CI 0.65-2.82, p = 0.413) had one or more cardiovascular or antidiabetic medicines discontinued. Regarding any medication, these percentages were 51% and 36%, (OR 1.8, CI 0.92-3.56, p = 0.085) respectively.

conclusionIncreased awareness and ability of community pharmacists to deprescribe medication and use of general practitioners' data, led community pharmacists and general practitioners to successfully conduct a more deprescribing-focused CMR in daily practice. Further research is needed to assess the necessity of additional training to optimize the deprescribing of cardiovascular and antidiabetic medication. The study was registered at The Netherlands Trial Register (registration no: NL8082).

Indexed as

Cardiovascular AgentsCardiovascular DiseasesCommunity Pharmacy ServicesDeprescriptionsDiabetes MellitusHypoglycemic AgentsPharmacistsAgedAged, 80 and overFemaleHumansMaleNetherlandsPolypharmacyProfessional RoleCardiovascular AgentsHypoglycemic AgentsFrail elderlyMedication reconciliationMedication reviewPharmacistsPolypharmacy

Identifiers

PMID39847313
PMCPMC12125148

What Socratic holds

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Registered trials

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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.