ArticleBMC geriatrics2021
General practitioners' deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults: an International Society for Pharmacoepidemiology-endorsed systematic review of methodology.American journal of epidemiology · 2025Pooled it
- Trial
- Baseline characteristics and comparability of older multimorbid patients with polypharmacy and general practitioners participating in a randomized controlled primary care trial.BMC family practice · 2021Trial
- Supporting General Practitioners to Deprescribe Benzodiazepines and Z-Drugs in Primary Care: Findings From a Modified Delphi Study.Basic & clinical pharmacology & toxicology · 2026Article
- Long-term beta blocker prescribing after myocardial infarction in European primary care (PRACTITIONER).BMC primary care · 2026Article
- Attitudes and confidence toward deprescribing: a survey among Italian general practitioners.BMC primary care · 2025Observational
- Exploration of Perceptions of Deprescribing Practices Among Doctors in a Low- and Middle-Income Country: A Mixed-Methods Study.Basic & clinical pharmacology & toxicology · 2025Article
- Prescriptions of Essentially Placebo Treatments Among General Practitioners in 21 Countries.JAMA network open · 2025Article
- Proton Pump Inhibitor Use in Older Adult Patients with Multiple Chronic Conditions: Clinical Risks and Best Practices.Journal of clinical medicine · 2025Review
- Article
- Factors Influencing General Practitioners' Deprescribing Decisions for Older Adults, with Insights into Frailty: a Qualitative Study in Greek Primary Care.Drugs & aging · 2025Article
- Barriers to Deprescribing Benzodiazepines in Older Adults in a Survey of European Physicians.JAMA network open · 2025Article
- Article
- Polypharmacy, drug-drug interactions and adverse drug reactions in older Chinese cancer patients: evidence from CHARLS.Frontiers in pharmacology · 2025Article
- Pharmacists' attitudes towards interprofessional collaboration to optimise medication use in older patients in Switzerland: a survey study.BMC health services research · 2024Article
- Proactive Polypharmacy Management Using Large Language Models: Opportunities to Enhance Geriatric Care.Journal of medical systems · 2024Article
- Evaluation of deprescription by general practitioners in elderly people with different levels of dependence: cross-sectional study.BMC primary care · 2024Article
- Evaluation of physicians' knowledge of deprescribing, deprescribing tools and assessment of factors affecting deprescribing process.BMC primary care · 2023Article
- Sex disparities in medication prescribing amongst patients with type 2 diabetes mellitus managed in primary care.Diabetic medicine : a journal of the British Diabetic Association · 2023Article
- Understanding older patients' willingness to have medications deprescribed in primary care: a protocol for a cross-sectional survey study in nine European countries.BMC geriatrics · 2022Article
Corrections and comments
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Authors and funding
41 authors at 20 institutions in 28 countries.
Funding
Abstract
backgroundGeneral practitioners (GPs) should regularly review patients' medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients' health. However, deprescribing can be challenging for physicians. This study investigates GPs' deprescribing decisions in 31 countries.
methodsIn this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs' deprescribing decisions.
resultsOf 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57).
interpretationThe majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.
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