Evidence map›Paper›PMID 33251567›Full record

ArticleDrugs & aging2021

Iterative Development of Clinician Guides to Support Deprescribing Decisions and Communication for Older Patients in Hospital: A Novel Methodology.

M H Duong, A J McLachlan, A A Bennett, N Jokanovic, D G Le Couteur, M T Baysari, D Gnjidic, F Blyth, S N Hilmer

Abstract read
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Article in Drugs & aging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 34% 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

5 citing papers in PubMed, 9 citations in OpenAlex.

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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 at 2 institutions in 1 country.

M H DuongKolling Institute, Royal North Shore Hospital and Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
A J McLachlanSchool of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
A A BennettNSW Therapeutic Advisory Group, Sydney, NSW, Australia.
N JokanovicKolling Institute, Royal North Shore Hospital and Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
D G Le CouteurAnzac Research Institute, Concord Hospital and Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
M T BaysariSydney School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
D GnjidicSchool of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
F BlythSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
S N HilmerKolling Institute, Royal North Shore Hospital and Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. sarah.hilmer@sydney.edu.au.ORCID 0000-0002-5970-1501
The University of Sydney · AUNew South Wales Department of Health · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesMedication review is an important component of the management of older hospital patients. Deprescribing (supervised withdrawal of inappropriate medicines) is one outcome of review. This study aimed to iteratively develop and test the usability of deprescribing guides, which support multidisciplinary clinicians to reduce inappropriate polypharmacy in older inpatients.

methodsDeprescribing guides for hospital clinicians were developed using a novel mixed-methods, ten-step process. Iterative development and usability testing were applied. This included content development through review of the literature; expert consensus through five rounds of feedback using a modified Delphi approach; and usability testing by 16 multidisciplinary hospital clinicians on hypothetical clinical scenarios involving observations, semi-structured interviews, and administration of the System Usability Scale.

resultsThis novel process was used to develop deprescribing guides that facilitate implementation of evidence on deprescribing in routine hospital care. The guides present evidence-based information in a format that aligns with workflows of multidisciplinary hospital clinicians. The guides were adapted for various clinical roles to navigate efficiently to suit differing workflow needs. Guides include unique communication support in the form of "preferred language". Clinicians can use the "preferred language" to apply the evidence to the individual patient and relay decisions between health providers and with patients/carers. The total System Usability Scale score was 80.6 ± 2.0 (mean ± standard error of the mean), indicating excellent usability. Guides have been developed using consistent format for nine medication classes that are common targets for deprescribing and are publicly available.

conclusionThis study demonstrates a novel approach to the development and implementation of evidence-based recommendations that support deprescribing in routine hospital care.

Indexed as

DeprescriptionsAgedCommunicationHospitalsHumansInpatientsPolypharmacy

Identifiers

PMID33251567
OpenAlexW3106718548

What OpenQuestion holds

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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.