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Deprescribing and medicines optimisation, two sides of the same coin? Considerations for design of interventional studies
  • Frank Moriarty,
  • Carmel Hughes
Frank Moriarty
RCSI University of Medicine and Health Sciences

Corresponding Author:[email protected]

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Carmel Hughes
Queen's University Belfast
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Interventions to promote deprescribing are an important focus of research. Key decisions for such interventions are whether to target one or multiple medicines, and whether the intervention scope is deprescribing, or also extends to other aspects of medicines optimisation. This article reflects on how these decisions impact on developing interventions and measuring outcomes. Many behavioural strategies are common to deprescribing and medicines optimisation, however operationalisation may differ. Aspects to consider include the burden of multiple simple interventions versus one complex intervention, the extent to which the approach to deprescribing can be specified as part of the intervention, and variability in how the intervention is delivered across patients and providers. Outcomes should be selected based on the intervention target and scope and the audience for whom evidence is being produced. These may include medication changes, and process outcomes to assess intervention delivery. Targeting single medications may allow for a focus on specific clinical or symptom-related outcomes, rather than more general outcomes such as adverse drug reactions. Cost-related outcomes are also important to inform implementation decisions, and modelling approaches may be more feasible for interventions targeting single medications.
14 Feb 2023Submitted to Basic & Clinical Pharmacology & Toxicology
14 Feb 2023Submission Checks Completed
14 Feb 2023Assigned to Editor
14 Feb 2023Review(s) Completed, Editorial Evaluation Pending
17 Feb 2023Reviewer(s) Assigned
29 Mar 2023Editorial Decision: Revise Minor
20 Apr 20231st Revision Received
21 Apr 2023Review(s) Completed, Editorial Evaluation Pending
21 Apr 2023Submission Checks Completed
21 Apr 2023Assigned to Editor
24 Apr 2023Reviewer(s) Assigned
11 May 2023Editorial Decision: Accept