Evidence map›Paper›PMID 34732234›Full record

ArticleTrials2021

Deprescribing to reduce polypharmacy: study protocol for a randomised controlled trial assessing deprescribing of anticholinergic and sedative drugs in a cohort of frail older people living in the community.

Ulrich Bergler, Nagham J Ailabouni, John W Pickering, Sarah N Hilmer, Dee Mangin, Prasad S Nishtala, Hamish Jamieson, Sponsor-investigator

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 35% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Trial
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

8 authors at 5 institutions in 4 countries.

Ulrich BerglerDepartment of Medicine, University of Otago, Christchurch, New Zealand.
Nagham J AilabouniUniSA Clinical & Health Sciences, Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia.
John W PickeringDepartment of Medicine, University of Otago, Christchurch, New Zealand.
Sarah N HilmerGeriatric Pharmacology, Faculty of Medicine and Health, Northern Clinical School, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Australia.
Dee ManginDepartment of Medicine, University of Otago, Christchurch, New Zealand.
Prasad S NishtalaDepartment of Pharmacy & Pharmacology, University of Bath, Bath, UK.
Hamish JamiesonDepartment of Medicine, University of Otago, Christchurch, New Zealand. hamish.jamieson@otago.ac.nz.ORCID http://orcid.org/0000-0002-2462-1595
Sponsor-investigator
University of Otago · NZBurwood Hospital · NZThe University of Sydney · AUUniversity of Bath · GBUniversity of South Australia · AU

Funding

New Zealand Health Research Council 17/363
6 · The paper itself

Abstract

backgroundTargeted deprescribing of anticholinergic and sedative medications in older people may improve their health outcomes. This trial will determine if pharmacist-led reviews lead to general practitioners deprescribing anticholinergic and sedative medications in older people living in the community. METHODS AND ANALYSIS: The standard protocol items: Recommendations for Interventional Trials (SPIRIT) checklist was used to develop and report the protocol. The trial will involve older adults stratified by frailty (low, medium, and high). This will be a pragmatic two-arm randomized controlled trial to test general practitioner uptake of pharmacist recommendations to deprescribe anticholinergic and sedative medications that are causing adverse side effects in patients. STUDY POPULATION: Community-dwelling frail adults, 65 years or older, living in the Canterbury region of New Zealand, seeking publicly funded home support services or admission to aged residential care and taking at least one anticholinergic or sedative medication regularly.

interventionNew Zealand registered pharmacists using peer-reviewed deprescribing guidelines will visit participants at home in the community, review their medications, and recommend anticholinergic and sedative medications that could be deprescribed to the participant's general practitioner. The total use of anticholinergic and sedative medications will be quantified using the Drug Burden Index (DBI). OUTCOMES: The primary outcome will be the change in total DBI between baseline and 6-month follow-up. Secondary outcomes will include entry into aged residential care, prolonged hospitalization, and death. DATA COLLECTION POINTS: Data will be collected at the time of interRAI assessments (T0), at the time of the baseline review (T1), at 6 months following the baseline review (T2), and at the end of the study period, or end of study participation for participants admitted into aged residential care, or who died (T3). ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Human, Disability and Ethics Committee: ethical number (17CEN265).

trial registrationClinicalTrials.gov ACTRN12618000729224 . Registered on May 2, 2018, with the Australian New Zealand Clinical Trials Registry.

Indexed as

DeprescriptionsPharmaceutical PreparationsAgedAustraliaCholinergic AntagonistsFrail ElderlyHumansHypnotics and SedativesPolypharmacyPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicCholinergic AntagonistsHypnotics and SedativesPharmaceutical PreparationsAnticholinergicDeprescribingDrug burden indexElderlyinterRAIPolypharmacySedatives

Identifiers

PMID34732234
PMCPMC8564597
OpenAlexW3163255710

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.