Identification of behaviour change techniques in deprescribing interventions: a systematic review and meta-analysis
Supplementary file - Tables S1 - S4
Supplementary File - Figures S1-S5
Raae Hansen, Christina
Kearney, Patricia M.
Sahm, Laura J.
Huibers, C. J. A.
Rutjes, Anne W. S.
John Wiley & Sons Ltd.
Aims: 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. Methods: 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: 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.
Behaviour change techniques , Deprescribing , Meta-analysis , Systematic review
Raae Hansen, C., O'Mahony, D., Kearney, P. M., Sahm, L. J., Cullinan, S., Huibers, C. J. A., Thevelin, S., Rutjes, A. W. S., Knol, W., Streit, S. and 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. doi:10.1111/bcp.13742
© 2018, the Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.