Trial reportBMJ open2017
A realist evaluation of patients' decisions to deprescribe in the EMPOWER trial.
Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 51 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Patient as a Driver of Change: an Intervention Study to Reduce the Use and Impact of Potentially Inappropriate Medications Among Older Adults
GABA-WHY Study: Deprescription of Gabapentinoids in Medical Inpatients
Who cites it
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Barriers and enablers to deprescribing of older adults and their caregivers: a systematic review and meta-synthesis.European geriatric medicine · 2023Pooled it
- Barriers and enablers for deprescribing benzodiazepine receptor agonists in older adults: a systematic review of qualitative and quantitative studies using the theoretical domains framework.Implementation science : IS · 2022Pooled it
- Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis.Addiction (Abingdon, England) · 2020Pooled it
- Behavioral Determinants of Older Adults' and Caregivers' Willingness to Deprescribe: A Systematic Review.Public health nursing (Boston, Mass.)Pooled it
- Trial
- Trial
- Hospital physicians' and older patients' agreement with individualised STOPP/START-based medication optimisation recommendations in a clinical trial setting.European geriatric medicine · 2022Trial
- Trial
- Understanding the Role of Communication in Deprescribing Behavior Change.Journal of the American Geriatrics Society · 2026Article
- Risk perception, attitudes, and quality of life in a multicomponent benzodiazepine deprescription strategy.Exploratory research in clinical and social pharmacy · 2025Article
- Development of a Brief Mindfulness-Informed Cognitive-Behavioural Therapy Intervention to Pair With Pharmacist-Led Benzodiazepine Tapering for Older Adults: The CSTARS Intervention.Basic & clinical pharmacology & toxicology · 2025Article
- Polypharmacy as a Chronic Condition: A Diagnostic Mindset for Safer and Smarter Care.Journal of clinical medicine · 2025Article
- Insights Into Pharmacist-Led Deprescribing of Benzodiazepines and Related Drugs: A Qualitative Study With Physicians and Pharmacists.Basic & clinical pharmacology & toxicology · 2025Article
- Reframing Polypharmacy: Empowering Medical Students to Manage Medication Burden as a Chronic Condition.Clinics and practice · 2025Article
- Meclizine Use and Subsequent Falls Among Patients With Dizziness.JAMA otolaryngology-- head & neck surgery · 2025Article
- Assessing Older Adults' Readiness for Adopting Fall Prevention Recommendations Using the Transtheoretical Stages of Change.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Vestibular Suppressant Utilization and Subsequent Falls Among Patients 65 Years and Older With Dizziness in the United States.Journal of the American Geriatrics Society · 2025Article
- Sleep should not be this difficult: An interpretive descriptive study of older adults' perspectives on behaviour change elements in Sleepwell and experiences with benzodiazepine discontinuation.Journal of sleep research · 2025Article
- Development of a medication review intervention by seconding a hospital pharmacist to primary care.Exploratory research in clinical and social pharmacy · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesSuccessful mechanisms for engaging patients in the deprescribing process remain unknown but may include: (1) triggering motivation to deprescribe by increasing patients' knowledge and concern about medications; (2) building capacity to taper by augmenting self-efficacy and (3) creating opportunities to discuss and receive support for deprescribing from a healthcare provider. We tested these mechanisms during theEliminating Medications through Patient Ownership of End Results (EMPOWER) () trial and investigated the contexts that led to positive and negative deprescribing outcomes.
designA realist evaluation using a sequential mixed methods approach, conducted alongside the EMPOWER randomised clinical trial.
settingCommunity, Quebec, Canada.
participants261 older chronic benzodiazepine consumers, who received the EMPOWER intervention and had complete 6-month follow-up data.
interventionMailed deprescribing brochure on benzodiazepines. MEASUREMENTS: Motivation (intent to discuss deprescribing; change in knowledge test score; change in beliefs about the risk-benefits of benzodiazepines, measured with the Beliefs about Medicines Questionnaire), capacity (self-efficacy for tapering) and opportunity (support from a physician or pharmacist).
resultsThe intervention triggered the motivation to deprescribe among 167 (n=64%) participants (mean age 74.6 years±6.3, 72% women), demonstrated by improved knowledge (risk difference, 58.50% (95% CI 46.98% to 67.44%)) and increased concern about taking benzodiazepines (risk difference, 67.67% (95% CI 57.36% to 74.91%)). Those who attempted to taper exhibited increased self-efficacy (risk difference, 56.90% (95% CI 45.41% to 65.77%)). Contexts where the deprescribing mechanisms failed included lack of support from a healthcare provider, a focus on short-term quality of life, intolerance to withdrawal symptoms and perceived poor health.
conclusionDeprescribing mechanisms that target patient motivation and capacity to deprescribe yield successful outcomes in contexts where healthcare providers are supportive, and patients do not have internal competing desires to remain on drug therapy. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT01148186.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.