Evidence map›Paper›PMID 38147454›Full record

ArticleJournal of the American Geriatrics Society2024

Evaluation of a benzodiazepine deprescribing quality improvement initiative for older adults in primary care.

Sulgi Chae, Emma Lee, Julia Lindenberg, Kaden Shen, Timothy S Anderson

Open access · bronzeAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 23% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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  4. Review
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

5 authors at 2 institutions in 1 country.

Sulgi ChaeDepartment of Pharmacy, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Emma LeeCenter for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Julia LindenbergDivision of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Kaden ShenNortheastern University Bouve College of Health Sciences, Boston, Massachusetts, USA.
Timothy S AndersonCenter for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.ORCID 0000-0002-5384-275X
Beth Israel Deaconess Medical Center · USNortheastern University · US

Funding

U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
Optimizing prescribing decisions for hospitalized older adults with chronic conditionsK76AG074878 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Timothy S Anderson · 2022 to 2026
$1.2M
NIA NIH HHS K76 AG074878NIA NIH HHS K76AG074878NIA NIH HHS R24 AG064025NIA NIH HHS R24AG064025
6 · The paper itself

Abstract

backgroundOlder adults are commonly prescribed long-term benzodiazepines for anxiety and insomnia despite evidence of risks and limited evidence of long-term benefits. Recent quality measures and guidelines have recommended benzodiazepine deprescribing, yet there is little real-world data on clinic-based deprescribing programs.

methodsWe developed a benzodiazepine deprescribing quality improvement program for older adults at a large US academic medical center. The program targeted adults aged 65 years and older who were prescribed chronic benzodiazepines by their primary care physician (PCP). PCPs were contacted to opt-out patients not suitable for deprescribing; then eligible patients were mailed a letter discussing patient-specific risks and advising them to discuss deprescribing with their PCP or a pharmacist who was available to support tapering. The primary outcomes were the number of patients who discussed deprescribing and who initiated a taper within 90 days of outreach.

resultsOf 504 older adults prescribed benzodiazepines, 133 (26%) were opted out by their PCPs leaving a cohort of 371 (median age 71 years [IQR 68-75], 58% female, 82% White). The median daily diazepam milligram equivalent was 5 mg (IQR 3-6 mg) and 30% were prescribed long-acting benzodiazepines. Three months following patient outreach, 97 patients (26%) had a documented discussion of benzodiazepines with their PCP or clinic pharmacist. Of these patients, 35 (36%) had documentation of a deprescribing discussion and 25 (26%) initiated a taper. At 12 months, 16 patients (64%) were tapered successfully, with nine (36%) patients taking a lower benzodiazepine dose and seven (28%) discontinuing benzodiazepines completely.

conclusionsA low-intensity benzodiazepine deprescribing outreach program led to deprescribing conversations for a minority of patients, but one-quarter of older adults who engaged in a conversation chose to taper and nearly two-thirds sustained reduced use. Incorporating benzodiazepine deprescribing into routine care may require more intensive population-health efforts to engage patients and clinicians.

Indexed as

BenzodiazepinesDeprescriptionsAgedAnxietyFemaleHumansMalePrimary Health CareQuality ImprovementBenzodiazepinesBenzodiazepinedeprescribingdrug taperprimary carequality improvement

Identifiers

PMID38147454
PMCPMC11018491
OpenAlexW4390237457

What OpenQuestion holds

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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.