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

2400 Participants Needed

Trial Summary

What is the purpose of this trial?

Our online, survey-based experiment will include 2,400 adults who are 65-years and older (n=1,200 each from United States and Australia). Each participant will be asked to give their opinions on a hypothetical patient scenario that has been developed by our diverse team in partnership with our stakeholder organizations.This work is expected to significantly contribute to our understanding of how older adults make decisions about deprescribing medications.

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 data supports the effectiveness of the treatment Leveraging Behavioral Science for deprescribing?

Research shows that deprescribing, which involves stopping or reducing unnecessary medications, can be effective in reducing the number of drugs older adults take. Studies suggest that patients are generally open to deprescribing, especially when they are educated about their medications and have good communication with their healthcare providers. ^{1 2 3 4 5}

Is deprescribing generally safe for humans?

Deprescribing interventions have been shown to be generally feasible and safe, and patients often find them acceptable. However, there are concerns about potential adverse drug withdrawal events (ADWEs) when stopping medications, and more methods are needed to assess these risks effectively. ^{1 2 6 7 8}

How is the Behavioral Science for Deprescribing treatment different from other treatments for reducing medication use?

This treatment is unique because it uses behavior change theories to help healthcare providers effectively reduce unnecessary medications, focusing on the process of deprescribing rather than just the medications themselves. It emphasizes understanding and changing behaviors of both patients and providers to improve the implementation and uptake of deprescribing practices. ^{1 3 9 10 11}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

References

1. United States pubmed.ncbi.nlm.nih.gov

Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

The Role of Patient Preferences in Deprescribing. [2018]

3. England pubmed.ncbi.nlm.nih.gov

Implementation considerations of deprescribing interventions: A scoping review. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Advancing the Science of Deprescribing: A Novel Comprehensive Conceptual Framework. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Patient-Reported Barriers and Enablers to Deprescribing Recommendations During a Clinical Trial (Shed-MEDS). [2023]

6. England pubmed.ncbi.nlm.nih.gov

Supporting medication discontinuation: provider preferences for interventions to facilitate deprescribing. [2022]

7. New Zealand pubmed.ncbi.nlm.nih.gov

Evaluating the Safety of an Educational Deprescribing Intervention: Lessons from the Optimize Trial. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Deprescribing in the context of multiple providers: understanding patient preferences. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Using the behavior change wheel to link published deprescribing strategies to identified local primary healthcare needs. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Leveraging implementation science to increase the translation of deprescribing evidence into practice. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

An Interprofessional Workshop to Enhance De-prescribing Practices Among Health Care Providers. [2021]