ArticlePharmacoepidemiology and drug safety2024
Validating claims-based definitions for deprescribing: Bridging the gap between clinical and administrative data.
Article in Pharmacoepidemiology and drug safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Article
- Patterns of deprescribing after an emergency department visit due to adverse drug events among concomitant users of antithrombotics and other medications.medRxiv : the preprint server for health sciences · 2026Article
- Sociodemographic differences in discontinuation of high-risk medications: a retrospective cohort study.npj aging · 2025Article
- Treatment patterns of symptomatic treatments for Alzheimer's disease and related dementias.BMC geriatrics · 2025Article
- The Reporting and Methodological Recommendations for Observational Studies Estimating the Effects of Deprescribing Medications (REMROSE-D) ISPE-Endorsed Guidance.Pharmacoepidemiology and drug safety · 2025Article
- Establishing a Validation Framework of Treatment Discontinuation in Claims Data Using Natural Language Processing and Electronic Health Records.Clinical pharmacology and therapeutics · 2025Article
- Discontinuation Categories Underlying Gaps in Dispensing for Six Medication Groups.Pharmacoepidemiology and drug safety · 2025Article
- Assessing causality in deprescribing studies: A focus on adverse drug events and adverse drug withdrawal events.Journal of the American Geriatrics Society · 2025Article
- Defining key deprescribing measures from electronic health data: A multisite data harmonization project.Journal of the American Geriatrics Society · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundLimited research has evaluated the validity of claims-based definitions for deprescribing.
objectivesEvaluate the validity of claims-based definitions of deprescribing against electronic health records (EHRs) for deprescribing of benzodiazepines (BZDs) after a fall-related hospitalization.
methodsWe used a novel data linkage between Medicare fee-for-service (FFS) and Part D with our health system's EHR. We identified patients aged ≥66 years with a fall-related hospitalization, continuous enrollment in Medicare FFS and Part D for 6 months pre- and post-hospitalization, and ≥2 BZD fills in the 6 months pre-hospitalization. Using a standardized EHR abstraction tool, we adjudicated deprescribing for a sub-sample with a fall-related hospitalization at UNC. We evaluated the validity of claims-based deprescribing definitions (e.g., gaps in supply, dosage reductions) versus chart review using sensitivity and specificity.
resultsAmong 257 patients in the overall sample, 44% were aged 66-74 years, 35% had Medicare low-income subsidy, 79% were female. Among claims-based definitions using gaps in supply, the prevalence of BZD deprescribing ranged from 8.2% (no refills) to 36.6% (30-day gap). When incorporating dosage, the prevalence ranged from 55.3% to 65.8%. Among the validation sub-sample (n = 47), approximately one-third had BZDs deprescribed in the EHR. Compared to EHR, gaps in supply from claims had good sensitivity, but poor specificity. Incorporating dosage increased sensitivity, but worsened specificity.
conclusionsThe sensitivity of claims-based definitions for deprescribing of BZDs was low; however, the specificity of a 90-day gap was >90%. Replication in other EHRs and for other low-value medications is needed to guide future deprescribing research.
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