Engaging Patients to Promote Deprescribing
Completed · Not applicable
Conditions studied: Medical Overuse, Inappropriate Prescribing, Deprescriptions
In brief
One mechanism to reduce potentially inappropriate medications is through deprescribing, a deimplementation-based approach to thoughtfully discontinue a medication a patient is currently prescribed. Many interventions to overcome deprescribing barriers target the provider, who is already overburdened. Although some believe providers have primary responsibility for deprescribing, patient-initiated discontinuation discussions can effectively facilitate deprescribing. In a single-site pilot study, the investigators successfully engaged VA Primary Care patients to facilitate deprescribing of select potentially inappropriate medications. The investigators now propose a multisite randomized controlled trial of engaging Veterans who may be deprescribing candidates. By study end, the investigators will have established the effectiveness of an innovative, low-tech, patient-focused intervention to promote deprescribing, thereby directly improving quality, safety, and value of VA care while also setting the stage for generalization of this approach to other potentially inappropriate medications.
Key facts
- Study ID
- NCT04294901
- Run by
- VA Office of Research and Development
- People needed
- 5946
- Starts
- 2021-03-29
- Expected to finish
- 2023-10-07
- Last updated by the study team
- 2025-05-18
Who can join
Age: any. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Veteran with a Primary Care appointment at one of three Veteran Affairs Medical Centers (including Community Based Outpatient Clinics)
- PPI Cohort:
- >90 consecutive days of PPI at any dose
- Diabetes Cohorts:
- HbA1c <7%
- At least one of Age >65 years
- Renal impairment
- Cognitive impairment
- either >90 consecutive days insulin or sulfonylurea or >90 consecutive days of >2 DM medications (neither of which is insulin or sulfonylurea)
- Gaba Cohort:
- >90 consecutive days with total daily dose >1800mg
You may not qualify if…
- PPI Cohort Exclusions:
- Diagnosis warranting PPI treatment
- Medication warranting PPI treatment
- Gaba Cohort Exclusions:
- Neuropathic pain
- Seizure disorder
- and/or Cancer-related pain
Where it is running
- San Francisco VA Medical Center, San Francisco, CA — San Francisco, California, United States
- VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA — Boston, Massachusetts, United States
- VA Central Western Massachusetts Healthcare System, Leeds, MA — Leeds, Massachusetts, United States
- James J. Peters VA Medical Center, Bronx, NY — The Bronx, New York, United States
Full record on ClinicalTrials.gov
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