Room for improvement in reporting of trials discontinuing long-term medication: a systematic review

Abstract

Background and objective: Discontinuation of inappropriate medication is widely recognized as an essential component of best prescribing practice. Physicians typically attempt to taper or stop medications on the basis of clinical experience, rather than using a systematic approach guided by evidence. We sought to evaluate if the reporting of deprescribing trials conducted in primary care is of sufficient quality and detail to allow replication in clinical practice.

Methods: This study presents a secondary analysis of data from a systematic review published in 2018, investigating the effects of discontinuation of chronic medication in primary care. Twenty-six publications reporting on 27 trials were included. The quality of reporting was assessed using the Template for Intervention Description and Replication (TIDieR) checklist.

Results: No study provided complete reporting on all TIDieR items. All studies provided a clear description and rationale for the intervention; however, details of the intervention were insufficiently reported in most studies, with high variability between studies. Consultation of secondary sources resulted in minimal additional information.

Conclusions: There are significant deficits in reporting methodological details of deprescribing interventions in primary care. It is likely that evidence-based deprescribing is not being implemented as routinely into health-care practice as it could be. Increasing the quality of intervention reporting is essential to avoid wastage of research resources and ought to be a focus for all discontinuation trials.

Keywords: Deprescribing; General practice; Medication discontinuation; Methodological quality; Primary care; Systematic review; Trial reporting.