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CompletedNCT04676282Updated Jan 13, 2022

Psychological and Clinical Factors That Predict Intent to Deprescribe Medications Among Older Adults

An observational study in Polypharmacy and Aging, sponsored by University of Michigan. Completed at 1 site in United States. Open to participants aged 65 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-01-13.

Sponsored by University of Michigan · Observational

Study type
Observational
Model
Case-only
Time perspective
Cross-sectional
Enrollment
10,184
Ages
65 Years and older
Sex
All
01

Study summary

The investigators are conducting two experimental surveys to explore clinical and psychological factors that influence older adults' willingness to stop medications in the face of polypharmacy.

Read the detailed description

Around one-half of older adults take one or more medications that are inappropriate or medically unnecessary. These medications can cause side effects that are unacceptable to patients. Several studies provide guidance to clinicians about the process of stopping specific types of medications (e.g., steps that clinicians can take to reduce and stop a medication for anxiety or difficulty sleeping). However, these approaches are not always successful. A critical gap with these approaches is they tend to focus on the medication, rather than the patient, and their individual needs.

Our research team seeks to learn more about factors that are important to patients when they consider reducing or stopping a medication. The investigators will do this by conducting two surveys each with 4,800 older adults across four countries (United States, United Kingdom, Netherlands, and Australia). Each participant will be asked to give their opinions on a hypothetical patient scenario that has been developed by our diverse team in partnership with our stakeholder organizations. In the first survey, the investigators will examine how the reason for using the medication (e.g. preventing a disease or treating symptoms of a disease) as well as the reason for a recommendation to stop the medication (e.g. lack of benefit vs. potential for harm) influence older adults' willingness to stop medications. In the second survey, the investigators will examine how different social and clinical factors and whether the participant is making a recommendation about oneself (as if they were the patient in the case) or on behalf of the patient in the case (e.g., if it was their friend) influence their willingness to stop medications. The investigators will work with Qualtrics, an international company that distributes surveys, to collect this data that does not include any identifying information.

The investigators anticipate that once the survey is designed and show that it is successful for studying patient perspectives about stopping medicines, it can then apply the same study approach to test the effect of other relevant factor that may influence the decision to stop or reduce a medication. The investigators anticipate that our research will significantly contribute to our understanding of how older adults make decisions about stopping medications. This information will be helpful to researchers and clinicians to ensure future services can be developed to best support patients to make decisions about stopping or reducing inappropriate or unnecessary medication.

02

Conditions studied

  • Polypharmacy
  • Aging
03

In context

Lead sponsor

University of Michigan is the lead sponsor of 1,475 studies on the registry; 196 are open to participants now.

Of its 162 completed or terminated interventional studies of FDA-regulated products, 128 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Adults 65 years and older who reside in a participating country

Inclusion criteria

  • 65 years and older
  • Resides in a participating country

Exclusion criteria

Exclusion Criteria:

  • None
05

Study design

Observational model
Case-only
Time perspective
Cross-sectional
Enrollment
10,184 participants (actual)
Patient registry
No

Groups and cohorts

  • Survey 1 Statin - May cause harm

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin as it may be causing harm.

    Other: Hypothetical Scenario

  • Survey 1 Stain - May lack benefit

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin as it may lack benefit.

    Other: Hypothetical Scenario

  • Survey 1 Statin - May cause harm and lack benefit

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin as it may be causing harm and lack benefit.

    Other: Hypothetical Scenario

  • Survey 1 PPI - May cause harm

    Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication. The primary care provider raises the idea of stopping the PPI as it may be causing harm.

    Other: Hypothetical Scenario

  • Survey 1 PPI - May lack benefit

    Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication. The primary care provider raises the idea of stopping the PPI as it may lack benefit.

    Other: Hypothetical Scenario

  • Survey 1 PPI - May cause harm and lack benefit

    Participants in this arm will be exposed to a scenario in which a patient takes a proton pump inhibitor (heartburn) medication. The primary care provider raises the idea of stopping the PPI as it may be causing harm and lack benefit.

    Other: Hypothetical Scenario

  • Survey 2 Statin - May cause harm and lack benefit

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin as it may be causing harm and lack benefit.

    Other: Hypothetical Scenario

  • Survey 2 Statin - Cardiologist

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin previously started by a cardiologist.

    Other: Hypothetical Scenario

  • Survey 2 Statin - Daughter Preference

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin but the patient's adult daughter prefers for her to continue the medication.

    Other: Hypothetical Scenario

  • Survey 2 Statin - Husband Stroke

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin but the patient's husband previously had a stroke after he stopped his statin.

    Other: Hypothetical Scenario

  • Survey 2 Statin - Flier

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin but the patient saw an educational flier about strokes in the waiting room.

    Other: Hypothetical Scenario

  • Survey 2 Statin - Difficulty Maintaining Lifestyle Changes

    Participants in this arm will be exposed to a scenario in which a patient takes a statin (cholesterol) medication. The primary care provider raises the idea of stopping the statin but the patient recognizes that they have had difficulty exercising and eating healthier foods.

    Other: Hypothetical Scenario

Interventions

  • OtherHypothetical Scenario

    Participants will be randomized to one of the arms. Each arm will contain a different hypothetical scenario.

06

What researchers measure

Primary outcomes

  1. Response to question statement "I think that Mrs. EF should follow her PCPs recommendation and stop taking simvastatin."

    Level of agreement with the primary care provider's recommendation to stop the medication presented in the hypothetical scenario (1=strongly disagree, 6=strongly agree)

    Time frame: 1 year

07

Study locations

1 site
  • University of Michigan
    Ann Arbor, Michigan 48109, United States
08

References and documents

Publications

  • Vordenberg SE, Weir KR, Jansen J, Todd A, Schoenborn N, Scherer AM. Harm and Medication-Type Impact Agreement with Hypothetical Deprescribing Recommendations: a Vignette-Based Experiment with Older Adults Across Four Countries. J Gen Intern Med. 2023 May;38(6):1439-1448. doi: 10.1007/s11606-022-07850-5. Epub 2022 Nov 14. PubMed 36376636 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 13, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04676282
Lead sponsor
University of Michigan
Collaborators
Maastricht University, University of Iowa, Johns Hopkins University, Newcastle University, University of Sydney
Responsible party
Vordenberg (Clinical Associate Professor, University of Michigan) — Principal investigator
First posted
Dec 21, 2020
Start date
Dec 17, 2020
Primary completion
Dec 31, 2021
Completion
Dec 31, 2021
Last update
Jan 13, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2022. You cannot join it, but the record below documents what was studied.

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