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Recommendations for outcome measurement for deprescribing intervention studies
Elizabeth A Bayliss1,2, Kathleen Albers1, Kathy Gleason1
1Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA.
Journal of the American Geriatrics Society
|June 1, 2022
Summary
Standardizing outcome measures in deprescribing research is crucial for generating reliable evidence. This study recommends clear definitions and appropriate data sources for future medication discontinuation studies.
Area of Science:
- Gerontology
- Pharmacology
- Evidence-Based Medicine
Background:
- Interpreting deprescribing intervention results is difficult due to inconsistent outcome definitions across studies.
- Polypharmacy is a significant issue in older adults, necessitating effective deprescribing strategies.
- Actionable evidence from deprescribing interventions is needed to guide clinical practice and policy.
Purpose of the Study:
- To characterize outcomes measured in deprescribing interventions.
- To recommend standardized approaches for measuring outcomes in future deprescribing studies.
- To develop a conceptual framework for interpreting deprescribing intervention outcomes.
Main Methods:
- Conducted a scoping literature review of 125 papers on deprescribing interventions for polypharmacy.
- Convened a 12-expert panel from the US Deprescribing Research Network for discussion and recommendations.
- Synthesized findings from the literature review and expert discussions.
Main Results:
- Identified common outcomes: medication discontinuation, appropriateness, and various clinical effects of medication reduction.
- Recommended defining clinically meaningful medication outcomes (e.g., number of medications, dose adjustments).
- Emphasized adequate sample size, follow-up duration, and appropriate data sources for capturing clinical outcomes (e.g., quality of life).
Conclusions:
- A conceptual model was developed to link medication changes to downstream clinical outcomes.
- Further research is needed on implementation outcomes and adverse drug withdrawal events.
- Standardized outcome measurement is essential for advancing deprescribing research and improving patient care.
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