For a study, researchers sought to determine how patient-provider discussions about and deprescribing of possibly inappropriate drugs were influenced by Direct-to-consumer teaching materials. They conducted a pre-post pilot experiment with a historical control group at an urban VA medical center. Patients were divided into two groups: patients at hypoglycemia risk, defined as diabetes diagnosis; prescription for insulin or sulfonylurea; hemoglobin A1c less than 7%; and age more than or equal to 65 years, renal insufficiency, or cognitive impairment. The intervention consisted of distributing medication-specific patient-centered EMPOWER (Eliminating Medications Through Patient Ownership of End Results) pamphlets 2 weeks before planned primary care appointments, suited to a Veteran patient population. Deprescribing was defined as the primary objective of clinical documentation of target medication discontinuation or dose decrease. The documentation of dialogue concerning the target drug (yes/possible vs no/absent) was the secondary objective. Age, sex, race, specific comorbidities, medications, and use were all covariates. Investigators performed chi-square testing to investigate the relationship between receiving brochures and each result. The 348 participants (253 intervention, 95 historical control) were mostly white and male, with an average age of more than or equal to 65. Intervention respondents had more deprescribing (36 [14.2%] vs 4 [4.2%], p=0.009) and talks concerning the target medicine (31 [12.3%] vs 1 [1.1%], p=0.001) than control subjects. A low-cost, low-technology strategy associated with increases in deprescribing and documenting patient-provider drug talks in a Veteran population was targeted mailings of EMPOWER booklets timed to a scheduled visit in primary care clinics. Using patients’ ability to initiate deprescribing discussions during clinical meetings was a promising method for lowering drug load and reducing adverse drug effects and harms.
Source:bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01655-5
