Patient-directed educational materials help promote desprescribing of certain medications

The provision of patient-directed educational materials prior to scheduled primary care appointments appears to have some benefit in terms of reducing the use of low-benefit or high-risk medications, according to a study.

The study included 5,071 patients who were cared for by 103 primary care practitioners (PCPs), with most being on proton pump inhibitors (n=2,624) and a small proportion being on gabapentin (n=121). Of these patients, 2,539 were included in the intervention group and received a medication-specific brochure, mailed during the intervention time, 2 to 3 weeks prior to upcoming primary care appointments. Meanwhile, the remaining 2,532 patients seen by the same PCPs at the same sites 1 year prior to the study intervention served as controls.

The primary outcome of deprescribing 6 months after the intervention was defined as complete discontinuation or any dose reduction of the target medication, determined using pharmacy dispensing data.

The overall rate of deprescribing was higher in the intervention group than in the control group (29.5 percent vs 25.8 percent). Multivariable logistic regression analysis showed that the intervention was associated with 21-percent greater odds of deprescribing (adjusted odds ratio, 1.21, 95 percent confidence interval, 1.05–1.38; p=0.008).

When stratified by medication group, the difference in deprescribing prevalence between the intervention and control groups was not significant for low-benefit medications (proton pump inhibitors: 29.4 percent vs 25.4 percent) and high-risk medications (gabapentin: 40.2 percent vs 36.2 percent; glucose-lowering drugs with hypoglycaemia risk: 27.3 percent vs 25.1 percent; p=0.90 for interaction). This indicated that the intervention was not more effective for a specific medication group compared with the others.