Evidence map›Paper›PMID 39289289›Full record

ArticleDrugs & aging2024

Co-Designing a Consult Patient Decision Aid for Continuation Versus Deprescribing Cholinesterase Inhibitors in People Living with Dementia.

Nagham J Ailabouni, Wade Thompson, Sarah N Hilmer, Lyntara Quirke, Janet McNeece, Alice Bourke, Chloe Furst, Emily Reeve

Abstract read
In one paragraph

Article in Drugs & aging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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.

Nagham J AilabouniPharmacy Australian Centre of Excellence, Health and Behavioural Science Department, School of Pharmacy, University of Queensland, 20 Cornwall Street, Brisbane, QLD, 4102, Australia. n.ailabouni@uq.edu.au.ORCID 0000-0002-6732-745X
Wade ThompsonDepartment of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0002-8268-4092
Sarah N HilmerNorthern Clinical School, Faculty of Medicine and Health, Kolling Institute of Medical Research, University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia.ORCID 0000-0002-5970-1501
Lyntara QuirkeDementia Advocate, Dementia Australia, Brisbane, QLD, Australia.
Janet McNeeceRoyal Adelaide Hospital, Northern Adelaide Local Health Network, Adelaide, SA, Australia.
Alice BourkeAged Care, Rehabilitation and Palliative Care (Medical), Northern Adelaide Local health Network, Adelaide, Australia.
Chloe FurstRoyal Adelaide Hospital, Northern Adelaide Local Health Network, Adelaide, SA, Australia.
Emily ReeveQuality Use of Medicines and Pharmacy Research Centre, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.ORCID 0000-0002-1405-999X

Funding

U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
Optimal Medication Management in Alzheimer's Disease and DementiaR33AG057289 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI BAYLISS, ELIZABETH A, BOYD, CYNTHIA MELINDA · 2019 to 2021
$2.2M
Generating Evidence on Deprescribing SafetyR01AG070047 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI BAYLISS, ELIZABETH A, BOYD, CYNTHIA MELINDA · 2024 to 2024
$542k
National Health and Medical Research Council 2023/GNT2025939National Health and Medical Research Council APP1105777National Health and Medical Research Council GNT1195460NIA NIH HHS R01 AG070047NIA NIH HHS R24 AG064025NIA NIH HHS R33 AG057289
6 · The paper itself

Abstract

BACKGROUND AND

objectiveAs dementia progresses, people living with dementia may take high-risk, unnecessary, or ineffective medicines. Cholinesterase inhibitors (ChEIs) may have benefit in some people with dementia; however, up to one third are continued when no longer necessary or safe. Our aim was to co-design a consult patient decision aid (CPtDA) to support shared decision making between healthcare professionals and consumers about continuing or deprescribing ChEIs.

methodsA systematic process was employed to design and test the CPtDA prototype. First, a steering group composed of healthcare professionals and a consumer representative was assembled. Guided by the International Patient Decision Aids Standards, the steering group defined the CPtDA's purpose, scope, and target audience and drafted the prototype for further testing. Interviews with consumers and healthcare professionals were conducted to gain feedback on the content, format, structure, comprehensibility and usability of the CPtDA prototype.

resultsAfter the steering group developed the CPtDA prototype, interviews were conducted with 11 consumers and six healthcare professionals. The content and format of the decision aid were improved iteratively over three rounds after consolidating the feedback at each round. The main changes included rewording the purpose of the decision aid and simplifying its layout and format. Participants reported that the decision aid is comprehensible and may be useful in practice.

conclusionsLimited available resources guide shared decision making about deprescribing. This study resulted in a co-designed and alpha-tested CPtDA for people living with dementia and carers to help them review the ongoing need for their ChEIs. Further research is needed to explore using the CPtDA in practice to support people living with dementia and their carers engage in the shared decision-making process about continuing or deprescribing their ChEIs. Our co-designed CPtDA could help people living with dementia and their carers review their goals of care alongside their healthcare professional. This may prompt conversations about appropriately using ChEIs and increase the uptake of deprescribing.

Indexed as

Cholinesterase InhibitorsDecision Support TechniquesDementiaDeprescriptionsAgedDecision MakingDecision Making, SharedFemaleHealth PersonnelHumansMaleCholinesterase Inhibitors

Identifiers

PMID39289289
PMCPMC11480166

What OpenQuestion holds

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LicenceCC BY-NC
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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.