Evidence map›Paper›PMID 40910519›Full record

ArticleFamily practice2025

Feasibility of implementing an intervention in general practice for deprescribing of glucose-lowering medication in overtreated elderly.

Charlotte Andriessen, Marieke T Blom, Beryl A C E van Hoek, Anna W de Boer, Petra Denig, Ron Herings, Angela de Rooij-Peek, Rob J van Marum, Jacqueline G Hugtenburg, Daniël van Raalte and 5 more

Abstract read
In one paragraph

Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. Trial
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

15 authors.

Charlotte AndriessenDepartment of General Practice, Amsterdam University Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0001-6862-1979
Marieke T BlomDepartment of General Practice, Amsterdam University Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Beryl A C E van HoekDepartment of General Practice, Amsterdam University Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Anna W de BoerDepartment of Public Health and Primary Care/Health Campus The Hague, LUMC, 2333 ZD Leiden, The Netherlands.
Petra DenigDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, 9700 AB Groningen, The Netherlands.
Ron HeringsPHARMO Institute for Drug Outcomes Studies, 3528 AE Utrecht, The Netherlands.
Angela de Rooij-PeekDiabetesvereniging Nederland, 3833 LD Leusden, The Netherlands.
Rob J van MarumDepartment of Geriatric Medicine, Jeroen Bosch Hospital, 5223 GZ 's-Hertogenbosch, The Netherlands.
Jacqueline G HugtenburgDepartment of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands.
Daniël van RaalteDepartment of Internal Medicine, Diabetes Center, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands.
Liselotte van BloemendaalDepartment of Internal Medicine-Geriatrics, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands.
Giel NijpelsDepartment of General Practice, Amsterdam University Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Marjan J WestermanDepartment of Epidemiology and Data Science, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands.
Rimke C VosDepartment of Public Health and Primary Care/Health Campus The Hague, LUMC, 2333 ZD Leiden, The Netherlands.
Petra J M EldersDepartment of General Practice, Amsterdam University Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.

Funding

ZonMW Grant Goed Gebruik Geneesmiddelen 848018102
6 · The paper itself

Abstract

backgroundElderly patients with Type 2 diabetes (T2D) are frequently overtreated with glucose-lowering medication.

objectiveThis feasibility study evaluated the implementation of a deprescribing programme (DPP) for general practices, consisting of education, a patient selection tool, practice visits, and an expert support panel, before scaling it in a randomized controlled trial.

methodsQuantitative evaluation included the number of patients with T2D eligible for deprescribing using medical records and study progress data. Qualitative evaluation entailed the analysis of minutes made during training, and interviews with health care providers (HCPs). The extended normalization process theory guided analysis.

resultsIn 10 practices, 55 out of 65 eligible patients were deprescribed glucose-lowering medication, with 22 restarts. Most execution steps were perceived as the practice nurse's responsibility, whereas the general practitioner needed to approve the deprescribing. Practice nurses found the educational training, including peer-to-peer sessions and practice visits, supportive of integrating deprescribing into practice. DPP procedures and tasks not part of the regular care process were not consistently performed. The DPP was adapted to minimize study tasks for HCPs and align study procedures to existing routine procedures.

conclusionImplementation of a DPP in general practice requires education, practice visits, and alignment of DPP components to regular care.

Indexed as

DeprescriptionsDiabetes Mellitus, Type 2General PracticeHypoglycemic AgentsAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleHypoglycemic Agentselderlygeneral practicehypoglycaemiaimplementationquality improvementtype 2 diabetes

Identifiers

PMID40910519
PMCPMC12411905

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.