Recommendation #1: Keep doing the “basic science” of
deprescribing and use it to inform interventions
Like most scientific endeavors, deprescribing has a translational
pathway, beginning with understanding fundamental questions and using
the answers to these questions to inform intervention development,
testing, and dissemination. Examples of foundational questions include
what are the medication problems that merit attention, who has these
problems, what stimulates and motivates patients and clinicians to
deprescribe in different clinical settings, and what are the right
outcomes to measure.
Unfortunately, we have often skipped to designing and testing
interventions without fully understanding these upstream questions,
resulting in less effective interventions and evaluating the wrong
outcomes when we study them. Some aspects of the “basic science” of
deprescribing, for example evaluating barriers and facilitators, have
been extensively studied. Yet, we have much to learn about many other
foundational questions and how to incorporate these learnings into
interventions.