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Deprescribing in Outpatient Internal Medicine Practices

NCT ID: NCT07226960

Last Updated: 2025-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-30

Study Completion Date

2026-04-30

Brief Summary

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The purpose of this study is to evaluate the impact of pharmacist-led medication reviews and deprescribing or de-escalation interventions on reducing the number of medications, falls, and hospitalizations, and improvement in quality of life in geriatric patients.

Detailed Description

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With increasing age, key pharmacokinetic processes such as first-pass metabolism, bioavailability, drug distribution, and clearance, are affected, necessitating dose adjustments and careful medication management. Despite these risks, medication regimens in elderly patients are often left unchanged over time. Deprescribing, the intentional reduction or discontinuation of medications, has been shown to improve quality of life, reduce fall risk, minimize cognitive impairment, and decrease adverse drug interactions. In this analysis, the PharmD will perform a comprehensive medication review with the patient and collaborate with the provider and patient through shared decision making to deprescribe and/or dose reduce medication therapy where risks may outweigh benefits for the patient.

Conditions

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Deprescribing

Keywords

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Polypharmacy medication regimens medication reviews geriatric patients

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, mixed methods, investigator-initiated pilot quality improvement analysis
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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medication review - deprescribing / de-escalation may occur

Internal medicine providers and PharmDs will identify patients for whom a medication review and potential deprescribing / de-escalation intervention may be beneficial, and make recommendations to adjust therapy as appropriate.

Group Type EXPERIMENTAL

medication review

Intervention Type BEHAVIORAL

Internal medicine providers and PharmDs will identify patients for whom a medication review and potential deprescribing / de-escalation intervention may be beneficial.

historical controls

No contact or intervention will be made with these patients, only retrospective chart review to gather data such as number of medications, hospitalizations, and falls. Patients included in the historical control arm will be matched to the intervention group based on sex, age, and number of medications as much as possible. The goal will be to include 50 patients in both the intervention and control arms.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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medication review

Internal medicine providers and PharmDs will identify patients for whom a medication review and potential deprescribing / de-escalation intervention may be beneficial.

Intervention Type BEHAVIORAL

Other Intervention Names

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potential deprescribing / de-escalation

Eligibility Criteria

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Inclusion Criteria

* 75 years or older
* taking 6 or more medications

Exclusion Criteria

* patients in hospice or palliative care
* in Skilled Nursing Facility
* receiving cancer/oncology treatment
Minimum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julia Clements, PharmD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Locations

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Wake Forest University Health Sciences

Winston-Salem, North Carolina, United States

Site Status

Countries

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United States

Central Contacts

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Anna Gambrell, PharmD

Role: CONTACT

Phone: 980-505-4718

Email: [email protected]

Kayla Marvin, PharmD

Role: CONTACT

Phone: 704-403-8650

Email: [email protected]

Facility Contacts

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Anna Gambrell, PharmD

Role: primary

Other Identifiers

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IRB00137786

Identifier Type: -

Identifier Source: org_study_id