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.