Brochures Aid Deprescribing Talks Between Patients and Docs

TOPLINE:

Patient-directed educational brochures show promise in increasing the likelihood of deprescribing discussions and promoting shared decision-making; however, this approach is less effective in Black patients, individuals with lower levels of education, and those who do not read the brochures.

METHODOLOGY:

• Deprescribing, the intentional discontinuation or dose reduction of medications for which risks outweigh benefits, can reduce potentially inappropriate medication use and associated harms.
• Researchers investigated the effect of patient-directed educational brochures on enhancing patient engagement and facilitating deprescribing discussions with primary care providers.
• They selected 3206 patients from three Veterans Affairs facilities who had appointments scheduled with their primary care providers and divided them into the following cohorts: Those taking proton-pump inhibitors (n = 2624), those taking gabapentin (n = 121), and those taking diabetes medications and having a risk for hypoglycemia (n = 461).
• Medication-specific brochures were mailed 2 weeks prior to each patient’s appointment between April 2021 and October 2022, followed by a mailed survey 2 weeks after their scheduled visits; the overall response rate to the survey was 43%.
• The primary outcome measure was the patient-reported occurrence of deprescribing discussions with their primary care providers.

TAKEAWAY:

• Nearly one in three respondents (29%) reported having a deprescribing discussion with their primary care provider during their brochure follow-up appointment.
• Non-Hispanic Black patients showed a lower likelihood of having deprescribing discussions with their primary care providers than White patients (odds ratio [OR], 0.47; 95% CI, 0.29-0.78), and higher vs lower levels of education were associated with an increased likelihood of having deprescribing discussions.
• Patients receiving diabetes medications were less likely to have deprescribing discussions than those receiving proton-pump inhibitors or gabapentin.
• Patients who read and engaged in brochure activities (OR, 2.23; 95% CI, 1.39-3.59) or contacted their primary care providers prior to their visits (OR, 2.47; 95% CI, 1.34-4.58) showed higher odds of having deprescribing discussions than those who did not read the brochures.

IN PRACTICE:

“Decisions should be individualized and consider each patient’s health conditions, values, and goals. Patient educational brochures are a low-cost mechanism to promote deprescribing discussions between patients and their primary care teams,” the study authors wrote.

SOURCE:

This study was led by Jacquelyn Pendergast, MS, Center for Health Optimization and Implementation Research, VA Boston Healthcare System and VA Bedford Healthcare System, Boston. It was published online in the Journal of General Internal Medicine.

LIMITATIONS:

The study population included predominantly male veterans using Veterans Affairs services, potentially limiting generalizability to other settings. Patient characteristics differed between respondents and nonrespondents, which may have affected the representativeness of the findings. The small size of the gabapentin cohort made it difficult to compare this medication group with the other two groups.

DISCLOSURES:

This study was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development. Some authors reported receiving grants and personal fees from the funding agencies and other sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.