Evidence map›Paper›PMID 30497404›Full record

ArticleBMC geriatrics2018

The deprescribing rainbow: a conceptual framework highlighting the importance of patient context when stopping medication in older people.

Adam Todd, Jesse Jansen, Jim Colvin, Andrew J McLachlan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 7% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
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  11. Article
  12. Article
  13. Challenges in Deprescribing among Older Adults in Post-Acute Care Transitions to Home.Journal of the American Medical Directors Association · 2024
    Article
  14. Medication misuse and overuse in community-dwelling persons with dementia.Journal of the American Geriatrics Society · 2023
    Article
  15. Review
  16. Article
  17. Medication work among nonagenarians: a qualitative study of the Newcastle 85+ cohort participants at 97 years old.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Article
  18. Article
  19. Article
  20. Observational
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

4 authors at 2 institutions in 2 countries.

Adam ToddSchool of Pharmacy, Faculty of Applied Sciences, Newcastle University, NE17RU, Newcastle upon Tyne, UK.
Jesse JansenWiser Healthcare, Sydney School of Public Health, The University of Sydney, Rm 226a, Edward Ford Building A27, Sydney, 2006, NSW, Australia. jesse.jansen@sydney.edu.au.ORCID 0000-0002-7739-0049
Jim ColvinHealth Consumers New South Wales, Sydney, Australia.
Andrew J McLachlanThe University of Sydney, Sydney Pharmacy School and Centre for Education and Research on Ageing, The University of Sydney, Sydney, 2006, NSW, Australia.
The University of Sydney · AUNewcastle University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The area of "deprescribing" has rapidly expanded in recent years as a positive intervention to reduce inappropriate polypharmacy and improve health outcomes for (older) people with multimorbidity. While our understanding of deprescribing as a process has greatly improved and existing approaches all have patient-centered elements, there is still limited literature exploring the importance of the individual patient context in deprescribing decision-making. This is clearly an important consideration to ensure that any deprescribing approach is ethical, respectful, and successful. To address this gap in the literature, we have developed a conceptual framework in the form of a rainbow - with five different deprescribing determinants - and place the person at the center of the deprescribing process. This framework is informed by literature on patient-centered care for older people and people with multimorbidity. We illustrate the potential application of this framework to a complex patient case to highlight the importance of the different clinical, psychological, social, financial and physical deprescribing determinants, and how this approach could be adopted by those working in clinical practice.

Indexed as

DeprescriptionsPolypharmacySocial SupportAgedAged, 80 and overDecision MakingDrug-Related Side Effects and Adverse ReactionsFemaleHumansInappropriate PrescribingMaleMultimorbidityPatient-Centered CarePatient ParticipationDeprescribingPerson-centered carePolypharmacyShared decision making

Identifiers

PMID30497404
PMCPMC6267905
OpenAlexW2901710875

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.