Table 2. Association of Bundled Hyperpolypharmacy Deprescribing Intervention vs Usual Care With Primary and Secondary Outcomesa.
| Group | Primary outcomes | Secondary outcomes | |||
|---|---|---|---|---|---|
| Mean No. of medications (95% CI) | Prevalence of geriatric syndrome, % (95% CI) | Mean No. of outpatient visits (95% CI) | Prevalence of an inpatient visit, % (95% CI) | Prevalence of an emergency department visit, % (95% CI) | |
| Usual care (n = 1233) | |||||
| Baseline | 13.6 (13.4 to 13.8) | 47.7 (44.9 to 50.5) | 11.6 (11.1 to 12.2) | 16.6 (14.6 to 18.7) | 37.1 (34.4 to 39.8) |
| Difference | −0.4 (−0.6 to −0.3) | 1.9 (−1.4 to 5.1) | −0.3 (−0.8 to 0.2) | 0.0 (−2.5 to 2.5) | 2.9 (−0.2 to 6.0) |
| Intention to treat (n = 1237) | |||||
| Baseline | 13.6 (13.4 to 13.8) | 42.9 (40.1 to 45.7) | 11.3 (10.7 to 11.8) | 15.4 (13.4 to 17.4) | 36.3 (33.6 to 38.9) |
| Difference | −0.4 (−0.6 to −0.2) | 2.9 (−0.3 to 6.1) | 0.1 (−0.4 to 0.6) | 1.6 (−0.9 to 4.1) | 4.3 (1.0 to 7.6) |
| Difference-in-differences | 0.02 (−0.3 to 0.3) | 1.0 (−3.5 to 5.6) | 0.4 (−0.3 to 1.1) | 1.6 (−1.9 to 5.1) | 1.4 (−3.1 to 5.9) |
| P valueb | .91 | .65 | .26 | .37 | .55 |
| As-treated (n = 1062) | |||||
| Baseline | 13.5 (13.3 to 13.7) | 42.6 (39.6 to 45.5) | 11.4 (10.8 to 11.9) | 14.6 (12.5 to 16.7) | 35.4 (32.5 to 38.3) |
| Difference | −0.4 (−0.6 to −0.2) | 3.2 (−0.3 to 6.7) | 0.2 (−0.4 to 0.7) | 2.2 (−0.6 to 4.9) | 4.0 (0.4 to 7.7) |
| Difference-in-differences | 0.1 (−0.2 to 0.3) | 1.3 (−3.4 to 6.1) | 0.5 (−0.3 to 1.2) | 2.2 (−1.5 to 5.9) | 1.1 (−3.6 to 5.9) |
| P valueb | .64 | .58 | .22 | .25 | .64 |
| Accepted deprescribing (n = 438) | |||||
| Baseline | 13.4 (13.1 to 13.7) | 42.2 (37.6 to 46.9) | 10.8 (10.0 to 11.7) | 12.6 (9.5 to 15.7) | 32.0 (27.6 to 36.3) |
| Difference | −0.6 (−0.9 to −0.3) | 0.7 (−4.8 to 6.2) | 0.4 (−0.5 to 1.2) | 2.2 (−2.0 to 6.6) | 3.6 (−1.9 to 9.2) |
| Difference-in-differences | −0.1 (−0.5 to 0.2) | −1.2 (−7.6 to 5.2) | 0.7 (−0.3 to 1.6) | 2.2 (−2.6 to 7.2) | 0.7 (−5.6 to 7.0) |
| P valueb | .48 | .72 | .16 | .37 | .82 |
a
Of the 1237 intervention patients, 1062 agreed to the deprescribing program, and 739 discussed a medication. For patients lost to follow-up (151 usual care and 154 intervention) or missing (15 usual care and 10 intervention), we assumed that medication count on day 365 equaled the medication count on day 0. The difference-in-differences compared the measure recorded during days 181 to 365 after allocation with the 180 days before allocation.
b
The Bonferroni correction with O’Brien-Fleming bounds for the 2 primary outcomes was 2-sided α = .0244.