Identification of Behaviour Change Techniques in Deprescribing Interventions: A Systematic Review and Meta-Analysis.

Hansen, C R; O'Mahony, D; Kearney, P M; Sahm, L J; Cullinan, S; Huibers, C J A; Thevelin, S; Rutjes, A W S; Knol, W; Streit, Sven; Byrne, S (2018). Identification of Behaviour Change Techniques in Deprescribing Interventions: A Systematic Review and Meta-Analysis. British journal of clinical pharmacology, 84(12), pp. 2716-2728. Wiley-Blackwell 10.1111/bcp.13742

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AIMS Deprescribing interventions safely and effectively optimise medication use in older people. However, questions remain about which componentsof interventions are key to effectively reduce inappropriate medication use. This systematic review examines the behaviour change techniques (BCTs) of deprescribing interventions and summarises intervention effectiveness on medication use and inappropriate prescribing. METHODS MEDLINE, EMBASE, Web of Science and Academic Search Complete and grey literature were searched for relevant literature. Randomised 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 summarised in meta-analyses. Medication appropriateness was assessed in according to 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 randomised controlled studies. RESULTS 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. CONCLUSIONS 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Rutjes, Anne and Streit, Sven

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0306-5251

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

28 Aug 2018 14:12

Last Modified:

26 Oct 2019 18:46

Publisher DOI:

10.1111/bcp.13742

PubMed ID:

30129139

BORIS DOI:

10.7892/boris.119532

URI:

https://boris.unibe.ch/id/eprint/119532

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