The following is a summary of “Effects of a multicomponent communication training to involve older people in decisions to DEPRESCRIBE cardiometabolic medication in primary care (CO-DEPRESCRIBE): protocol for a cluster randomized controlled trial with embedded process and economic evaluation,” published in the June 2024 issue of Primary Care by Stuijt et al.

This study aims to evaluate the effectiveness of a blended training program, CO-DEPRESCRIBE, designed to facilitate the deprescribing of cardiometabolic medications in older adults within primary care settings. Despite clinical guidelines endorsing deprescribing for cardiovascular and diabetes medications, implementation remains challenging. The cluster-randomized trial will involve local pharmacy-general practice teams in the Netherlands, randomly assigned to either conduct standard clinical medication reviews (control group) or undergo the CO-DEPRESCRIBE training (intervention group). 

Participants aged 75 and older who are using specific medications (diabetes drugs, antihypertensives, statins) and eligible for review will be included. The CO-DEPRESCRIBE intervention comprises 5 modules focused on patient-centered communication and shared decision-making, supported by practical tools. The primary outcome is the proportion of patients with at least one cardiometabolic medication deintensified. Secondary outcomes encompass patient involvement in decision-making, healthcare provider communication skills, health and medication-related outcomes, attitudes toward deprescribing, medication regimen complexity, and health-related quality of life. 

Safety and cost parameters will also be assessed. The study anticipates 167 patients per study arm for final intention-to-treat analysis, factoring in potential loss to follow-up, with each of the 40 teams recruiting 10 patients. Baseline and 6-month follow-up assessments and process and cost-effectiveness evaluations will inform the outcomes. It is hypothesized that the CO-DEPRESCRIBE training will foster proactive and patient-centered deprescribing practices, thereby enhancing the sustainable implementation of deprescribing in primary care.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02465-7