Aims Methods Deprescribing interventions safely and effectively optimize medication use in older people. However, questions remain about which components of interventions are key to effectively reduce inappropriate medication use. This systematic review examines the behaviour change techniques (BCTs) of deprescribing interventions and summarizes intervention effectiveness on medication use and inappropriate prescribing. MEDLINE, EMBASE, Web of Science and Academic Search Complete and grey literature were searched for relevant literature. Randomized controlled trials (RCTs) were included if they reported on interventions in people aged >= 65 years. The BCT taxonomy was used to identify BCTs frequently observed in deprescribing interventions. Effectiveness of interventions on inappropriate medication use was summarized in meta-analyses. Medication appropriateness was assessed in accordance with STOPP criteria, Beers' criteria and national or local guidelines. Between-study heterogeneity was evaluated by I-squared and Chi-squared statistics. Risk of bias was assessed using the Cochrane Collaboration Tool for randomized controlled studies. Results Conclusions Of the 1561 records identified, 25 studies were included in the review. Deprescribing interventions were effective in reducing number of drugs and inappropriate prescribing, but a large heterogeneity in effects was observed. BCT clusters including goals and planning; social support; shaping knowledge; natural consequences; comparison of behaviour; comparison of outcomes; regulation; antecedents; and identity had a positive effect on the effectiveness of interventions. In general, deprescribing interventions effectively reduce medication use and inappropriate prescribing in older people. Successful deprescribing is facilitated by the combination of BCTs involving a range of intervention components.

Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis / Hansen, Cr; O'Mahony, D; Kearney, Pm; Sahm, Lj; Cullinan, S; Huibers, Cja; Thevelin, S; Rutjes, A; Knol, W; Streit, S; Byrne, S. - In: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY. - ISSN 0306-5251. - 84:12(2018), pp. 2716-2728. [10.1111/bcp.13742]

Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis

Rutjes A;
2018

Abstract

Aims Methods Deprescribing interventions safely and effectively optimize medication use in older people. However, questions remain about which components of interventions are key to effectively reduce inappropriate medication use. This systematic review examines the behaviour change techniques (BCTs) of deprescribing interventions and summarizes intervention effectiveness on medication use and inappropriate prescribing. MEDLINE, EMBASE, Web of Science and Academic Search Complete and grey literature were searched for relevant literature. Randomized controlled trials (RCTs) were included if they reported on interventions in people aged >= 65 years. The BCT taxonomy was used to identify BCTs frequently observed in deprescribing interventions. Effectiveness of interventions on inappropriate medication use was summarized in meta-analyses. Medication appropriateness was assessed in accordance with STOPP criteria, Beers' criteria and national or local guidelines. Between-study heterogeneity was evaluated by I-squared and Chi-squared statistics. Risk of bias was assessed using the Cochrane Collaboration Tool for randomized controlled studies. Results Conclusions Of the 1561 records identified, 25 studies were included in the review. Deprescribing interventions were effective in reducing number of drugs and inappropriate prescribing, but a large heterogeneity in effects was observed. BCT clusters including goals and planning; social support; shaping knowledge; natural consequences; comparison of behaviour; comparison of outcomes; regulation; antecedents; and identity had a positive effect on the effectiveness of interventions. In general, deprescribing interventions effectively reduce medication use and inappropriate prescribing in older people. Successful deprescribing is facilitated by the combination of BCTs involving a range of intervention components.
2018
84
12
2716
2728
Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis / Hansen, Cr; O'Mahony, D; Kearney, Pm; Sahm, Lj; Cullinan, S; Huibers, Cja; Thevelin, S; Rutjes, A; Knol, W; Streit, S; Byrne, S. - In: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY. - ISSN 0306-5251. - 84:12(2018), pp. 2716-2728. [10.1111/bcp.13742]
Hansen, Cr; O'Mahony, D; Kearney, Pm; Sahm, Lj; Cullinan, S; Huibers, Cja; Thevelin, S; Rutjes, A; Knol, W; Streit, S; Byrne, S
File in questo prodotto:
File Dimensione Formato  
2018Hansen_Rutjes_ BrJClinPharmacol.pdf

Open access

Tipologia: Versione pubblicata dall'editore
Dimensione 883.6 kB
Formato Adobe PDF
883.6 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1286654
Citazioni
  • ???jsp.display-item.citation.pmc??? 17
  • Scopus 46
  • ???jsp.display-item.citation.isi??? 44
social impact