Behavioral Science for Deprescribing

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how older adults decide to stop or start medications. Participants will read various scenarios about starting or stopping a medication, considering factors like risk and benefit. The researchers aim to use insights from behavioral science (the study of how people make decisions) to improve decision-making about deprescribing (reducing or stopping medications). Individuals aged 65 or older living in the U.S. or Australia might be eligible to participate. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance medication decision-making for older adults.

Do I need to stop taking my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this method is safe for understanding deprescribing decisions?

Research has shown that using behavioral science to stop unnecessary medications can be safe and beneficial for older adults. Studies have found that deprescribing reduces the number of unneeded drugs, lowering the risk of harmful side effects.

For example, research indicates that more than half of older adults take medications that might do more harm than good. Stopping these medications may help patients avoid health issues that could lead to hospital visits. One study found that electronic tools assisting with deprescribing resulted in fewer unwanted drug effects.

Overall, evidence suggests that deprescribing, when guided by behavioral science, is generally safe and can improve health by reducing medication-related risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how behavioral science can guide decisions about starting or stopping medications. Unlike traditional approaches that focus solely on clinical data, this trial taps into how patients perceive risks and benefits, which can greatly influence their medication choices. By understanding these behavioral factors, the trial aims to improve how doctors and patients make decisions together, potentially leading to safer and more personalized healthcare.

What evidence suggests that this trial's treatments could be effective for deprescribing?

This trial will explore various scenarios using behavioral science to reduce medication use among older adults. Research has shown that these methods can make prescriptions more suitable, leading to fewer unnecessary medications. Additionally, some studies suggest that properly reducing medication may improve physical health and quality of life. By focusing on behavior change, these strategies aim to make medication use safer and more effective for older adults. Participants in this trial will encounter scenarios, such as starting or stopping medication based on potential risks or benefits, to evaluate the impact of behavioral science on deprescribing. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adults aged 65 and older from the United States and Australia. Participants will be asked to share their views on medication management in a hypothetical patient scenario.

Inclusion Criteria

I am 65 or older and live in Australia or the US.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Survey-based Experiment

Participants provide opinions on hypothetical patient scenarios regarding medication optimization

1 year

Follow-up

Participants are monitored for their preferences and decisions regarding medication optimization

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Leveraging Behavioral Science

Trial Overview The study aims to understand how older adults decide about stopping or reducing medications through an online survey that presents them with a hypothetical situation.

How Is the Trial Designed?

Group I: Stop medication - Potential for harm Experimental Treatment 2 Interventions

Participants read a hypothetical scenario where a doctor suggests stopping the medication due to the potential for harm.

Group II: Stop medication - Lack of benefit Experimental Treatment 2 Interventions

Participants read a hypothetical scenario where a doctor suggests stopping the medication due to a lack of benefit.

Group III: Start medication - Lower chance of future health problems Experimental Treatment 2 Interventions

Participants read a hypothetical scenario where a doctor recommends starting a new medication to lower their chances of experiencing significant health problems.

Group IV: Start medication - Higher risk without medication Experimental Treatment 2 Interventions

Participants read a hypothetical scenario where a doctor recommends starting a new medication because they could experience a higher risk of serious health problems without it

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

University of Sydney

Collaborator

Trials

208

Recruited

417,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6255994/

Identification of behaviour change techniques in deprescribing ... Deprescribing interventions are effective in reducing the number of drugs taken by patients and improving prescribing inappropriateness. Their success may be ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10337166/

Outcomes in deprescribing implementation trials and ... This review provides an update on the implementation of gold standard deprescribing studies in clinical practice.

3. bpspubs.onlinelibrary.wiley.com bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.16200

The effect of deprescribing interventions on mortality and ... The primary outcome was mortality. Secondary outcomes were adverse drug withdrawal events, physical health, cognitive function, quality of life ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1551741120302278

Deprescribing interventions in primary health care mapped ... This scoping review aimed to identify and characterize strategies for deprescribing in primary health care and map the strategies to the Behaviour Change Wheel ...

5. research.aota.org research.aota.org/ajot/article/71/6/7106240010p1/6351/Intervention-to-Improve-Medication-Management

Intervention to Improve Medication Management: Qualitative ... RESULTS. The occupational therapy intervention group reported greater improvements in medication management and implemented twice as many new ...

6. bmcgeriatr.biomedcentral.com bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-04155-y

Outcomes in deprescribing implementation trials and ... In most studies, this outcome type focused on the number of drugs deprescribed or the number or percentage of patients for whom the ...

7. bpspubs.onlinelibrary.wiley.com bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.14595

The role of behavioural science in changing deprescribing ... Over 50% of older people are prescribed a medicine with more harm than benefit leading to avoidable morbidity, hospitalisation and mortality.

8. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK600387/

Deprescribing To Reduce Medication Harms in Older Adults Deprescribing has the potential to improve multiple aspects of patient safety and quality of care, including by reducing drug burden, ADEs, and morbidity.

9. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788297

The MedSafer Study—Electronic Decision Support for ... This randomized clinical trial examines the impact of electronic decision support on postdischarge adverse drug events and deprescribing ...