Advancing the Field of Deimplementation: Perspectives on Low-Value Clinical Preventive Services

Area of Science:

• Health Services Research
• Preventive Medicine
• Implementation Science

Background:

• Clinical preventive services aim to prevent disease but some may lack benefit or cause harm.
• Discontinuing low-value health services, known as deimplementation, is increasingly emphasized.
• This project focused on expert input regarding the deimplementation of low-value clinical preventive services.

Purpose of the Study:

• To gather expert input on the current state of deimplementation for low-value clinical preventive services.
• To identify challenges and opportunities in discontinuing ineffective health services.
• To inform future research and practice in health services deimplementation.

Main Methods:

• An environmental scan of existing deimplementation work was conducted.
• Key informant interviews with 4 individuals were performed.
• A facilitated discussion with a 12-member technical expert panel was held, using an iterative, inductive approach to synthesize findings.

Main Results:

• Few frameworks or empirical studies specifically address deimplementation of low-value clinical preventive services.
• Experts advised revising terminology to improve patient and family understanding.
• Experts recommended refining existing deimplementation frameworks and testing specific strategies, while noting potential equity concerns and emphasizing patient engagement.

Conclusions:

• Future work should advance methods for deimplementation research.
• Testing deimplementation strategies tailored to low-value clinical preventive services is crucial.
• Engaging patients, families, and communities is essential for successful deimplementation efforts.