Family Medicine
Partner With Us
Advertisement
From the Journals

Patient-Centered Approach to Medication Deprescribing

Mailing educational brochures before appointments led to a 29.5% deprescribing rate, compared to 25.8% in controls, suggesting a simple intervention can significantly shift medication management.

Conexiant

Mailing patient-directed educational materials before primary care visits increased deprescribing rates for high-risk medications, according to a recent study.

Researchers evaluated the impact of patient-directed educational materials on deprescribing potentially low-benefit and high-risk medications. This pragmatic nonrandomized clinical trial included 5,071 patients treated by 103 clinicians at three U.S. Veterans Affairs medical centers between April 2021 and October 2022.

The intervention group (2,539 patients) received educational brochures 2 to 3 weeks before their primary care appointments, while the control group (2,532 patients) consisted of historical data from patients seen by the same clinicians a year earlier. The study focused on deprescribing proton pump inhibitors (PPIs), high-dose gabapentin, and diabetes medications associated with hypoglycemia risk.

Results showed a significant increase in deprescribing in the intervention group, with 29.5% of patients reducing or discontinuing their medication, compared to 25.8% in the control group. In an unadjusted model, the intervention cohort had 1.17 times higher odds of deprescribing (95% confidence interval, 1.03-1.33; P = .02) compared to the control group. In the adjusted model, the odds were 1.21 times greater (95% CI, 1.05-1.38; P = .008).

Deprescribing rates varied slightly by medication type. For PPIs, 29.4% of the intervention group reduced or discontinued use compared to 25.4% in the control group. For gabapentin, 40.2% of the intervention group deprescribed, versus 36.2% in the control group. For diabetes medications linked to hypoglycemia risk, the rates were 27.3% and 25.1%, respectively.

Although the increase in deprescribing was modest, the findings suggest that patient-directed educational materials can promote changes in medication management. The study, published in JAMA Internal Medicine, highlights that these materials may be more effective for certain medications, like gabapentin, than others.

Full disclosures are available in the published study.