Evidence map›Paper›PMID 28804870›Full record

Trial reportJournal of the American Geriatrics Society2017

Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04331535 (Pragmatic Randomized Trial of Polygenic Risk Scoring for Common Diseases in Primary Care), which is not on this map. Cited by 48 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 15 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04331535 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Pragmatic Randomized Trial of Polygenic Risk Scoring for Common Diseases in Primary Care

TypeinterventionalSponsorBoston VA Research Institute, Inc.Ran2020 to 2025Enrolled1,076ConditionsCoronary Artery Disease, Atrial Fibrillation, Type 2 Diabetes, Colorectal CancerArmsPolygenic risk score (PRS)
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 15 syntheses or guidelines pooled it.

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  4. Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
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  7. Communication Processes Related to Decision-Making in Medication Management Between Healthcare Providers, Older People and Their Carers: A Systematic Review.Health expectations : an international journal of public participation in health care and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Terri R FriedClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Kristina M NiehoffClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Richard L StreetDepartment of Communication, Texas A&M University, College Station, Texas.
Peter A CharpentierProgram on Aging, Yale School of Medicine, New Haven, Connecticut.
Nallakkandi RajeevanClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Perry L MillerClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Mary K GoldsteinPalo Alto Geriatric Research, Education and Clinical Center and Medical Service, Veterans Affairs Palo Alto Health Care System, Palo Alto.
John R O'LearyClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Brenda T FentonPain Research, Informatics, Multi-morbidities, and Education Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
YALE UNIVERSITY CLINICAL AND TRANSLATIONAL SCIENCE AWARD PROGRAMUL1RR024139 · NCRR · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2006 to 2011
$56.8M
Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Denise Esserman · 2002 to 2026
$37.9M
NCATS NIH HHS UL1 TR001863NCRR NIH HHS UL1 RR024139NIA NIH HHS P30 AG021342
6 · The paper itself

Abstract

objectivesTo examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing.

designRandomized clinical trial.

settingPrimary care clinics at a Veterans Affairs Medical Center.

participantsVeterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128).

interventionTRIM extracts information on medications and chronic conditions from the EHR and contains data entry screens for information obtained from brief chart review and telephonic patient assessment. These data serve as input for automated algorithms identifying medication reconciliation discrepancies, potentially inappropriate medications (PIMs), and potentially inappropriate regimens. Clinician feedback reports summarize discrepancies and provide recommendations for deprescribing. Patient feedback reports summarize discrepancies and self-reported medication problems. MEASUREMENTS: Primary: subscales of the Patient Assessment of Care for Chronic Conditions (PACIC) related to shared decision-making; clinician and patient communication. Secondary: changes in medications.

results29.7% of TRIM participants and 15.6% of control participants provided the highest PACIC ratings; this difference was not significant. Adjusting for covariates and clustering of patients within clinicians, TRIM was associated with significantly more-active patient communication and facilitative clinician communication and with more medication-related communication among patients and clinicians. TRIM was significantly associated with correction of medication discrepancies but had no effect on number of medications or reduction in PIMs.

conclusionTRIM improved communication about medications and accuracy of documentation. Although there was no association with prescribing, the small sample size provided limited power to examine medication-related outcomes.

Indexed as

Decision Support Systems, ClinicalDeprescriptionsPotentially Inappropriate Medication ListSoftwareAgedAged, 80 and overChronic DiseaseCommunicationElectronic Health RecordsFemaleHumansMaleMedication ReconciliationPolypharmacyUnited StatesUnited States Department of Veterans Affairscommunicationmedication prescribingpolypharmacy

Identifiers

PMID28804870
PMCPMC5641237

What OpenQuestion holds

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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.