Evidence map›Paper›PMID 41973408›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2026

Navigating Medication Risk in the ED: Communication Preferences of Older Adults Regarding Deprescribing.

Grace Burud, Emma Lopes, Smeet Bhimani, Parag Goyal, Joshua Niznik, Kaitlin Donvan, Andrew Dodson, Kevin Musgrow, Greta Anton, Ula Hwang and 2 more

Abstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2026. 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. Attitudes Toward Deprescribing Among Older Adults Seeking Care in the Emergency Department.Journal of the American College of Emergency Physicians open · 2026
    Article
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

12 authors.

Grace BurudUniversity of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.ORCID 0009-0001-2968-4114
Emma LopesUniversity of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Smeet BhimaniDepartment of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Parag GoyalDepartment of Medicine, Weill Cornell Medicine, New York, New York, USA.ORCID 0000-0001-7474-3737
Joshua NiznikDivision of Geriatric Medicine and Center for Aging and Health, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina, USA.
Kaitlin DonvanEshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Andrew DodsonEshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Kevin MusgrowUniversity of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Greta AntonDepartment of Pharmacy, University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Ula HwangDepartment of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Michelle L MeyerDepartment of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Martin F CaseyDepartment of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.ORCID 0000-0002-5049-012X

Funding

U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
Growing the Geriatric Emergency care Applied Research (GEAR 1.1) network: Expanding and sustaining an emergency care aging study infrastructure.R33AG058926 · NIA · YALE UNIVERSITY · PI Ula Y Hwang, Daniella Meeker · 2020 to 2026
$4.6M
SHORT-TERM RESEARCH TRAININGT35DK007386 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Evan Samuel Dellon · 1986 to 2026
$4.1M
Developing a foundation for a novel emergency department-based intervention to address inappropriate aspirinR03AG089044 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CASEY, MARTIN FRANCIS · 2024 to 2024
$310k
NIA NIH HHS R03 AG089044NIA NIH HHS R03AG089044NIA NIH HHS R24 AG064025NIA NIH HHS R33AG058926NIDDK NIH HHS T35 DK007386NIDDK NIH HHS T35-DK007386The Maurico Castillo, MD Scholars ProgramUS Deprescribing Research Network R24AG064025
6 · The paper itself

Abstract

objectivesPatients and experts agree that potentially inappropriate medications should be reconsidered after adverse drug events (ADEs), yet emergency providers are often hesitant to discuss deprescribing in deference to outpatient prescribers. We sought to explore patient communication preferences for deprescribing in the emergency department (ED) after an ADE.

methodsWe conducted a cross-sectional survey study of older adults aged 65 years and older presenting to a southeastern, academic ED from June 2024 to October 2024. While awaiting results, eligible participants completed a best-worst scaling survey comparing seven potential ED communication strategies for prompting deprescription of daily aspirin. The primary analysis tested whether an ED-initiated "therapeutic pause" ("Considering your bleeding, I would like you to hold your aspirin until you can discuss with your primary care provider") was preferred by > 50% of participants over a generic discharge referral to a primary care provider through a one-sided binomial test. Secondary analyses used conditional logistic regression to evaluate relative preference across all seven deprescribing phrases.

resultsIn total, 102 patients completed the survey with a mean (SD) age of 75 years old (std dev 7). Among all respondents, 62% (95% CI, 52%-71%) preferred an ED-initiated 'therapeutic pause' of aspirin with primary care follow-up to the generic PCP deferral approach (p = 0.01). The least preferred statement was a strict deprescribing recommendation ("I do not think you need aspirin anymore"), which was selected as the least-favored communication approach in 65% of choice tasks. In conditional logistic regression, the therapeutic pause had greater odds of being selected as most preferred compared to the least preferred phrase (OR 9.3; 95% CI, 6.3-13.8).

conclusionOur study suggests that ED physicians may take a proactive approach in addressing potential deprescribing in caring for patients with ADEs, such as initiating a therapeutic pause of aspirin after an episode of bleeding.

Indexed as

CommunicationDeprescriptionsDrug-Related Side Effects and Adverse ReactionsEmergency Service, HospitalInappropriate PrescribingPatient PreferenceAgedAged, 80 and overAspirinCross-Sectional StudiesFemaleHumansMaleSurveys and QuestionnairesAspirin

Identifiers

PMID41973408
PMCPMC13154728

What Socratic holds

Textmetadata
LicenceTDM
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.