{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T06:50:33Z","timestamp":1793515833413,"version":"4.5.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,3,24]]},"abstract":"\n Importance<\/jats:title>\n Potentially inappropriate medications are commonly overprescribed to older adults. Although electronic health record (EHR)\u2013based tools can increase use of evidence-based medications, their ability to reduce prescription of potentially inappropriate medications remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To test the effects of 2 EHR interventions, designed using behavioral science techniques, on the deprescribing of potentially inappropriate medications compared with usual care in older patients.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n In this 3-group parallel randomized clinical trial, 201 primary care physicians (PCPs) in an academic center in Massachusetts were cluster-randomized in November 2022. Follow-up ended March 15, 2024. The intervention focused on patients of randomized PCPs who were 65 years or older, had a PCP visit between November 10, 2022, and March 15, 2024, and were prescribed at least 90 pills of benzodiazepines, nonbenzodiazepine sedative hypnotics, or at least 2 anticholinergic medications in the past 180 days.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n PCPs were randomized to usual care (no intervention) or to 1 of 2 sequential EHR interventions: a precommitment intervention, in which an EHR message was sent to the physician during the first patient visit asking the PCP to initiate deprescribing discussions with a second reminder EHR message at the patient\u2019s second visit encouraging deprescribing; and a boostering intervention, in which PCPs received a notification encouraging deprescribing at the first patient visit and an in-basket reminder 4 weeks later.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was deprescribing at least 1 medication on or after the first patient visit though the end of follow-up. Deprescribing was defined as physician-directed discontinuation or medication tapering assessed at the patient level using EHR data. Generalized estimating equations with a log link and binary-distributed errors were used for analyses, adjusting for clustering and multiple testing using Holm-Bonferroni corrections.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 1146 participants (mean age, 73.6 years [SD, 6.4]; 69.7% female, mean follow-up, 289.9 days), 373 (32.5%) had at least 1 medication deprescribed: 145 (36.8%) in the precommitment group, 122 (34.3%) in the boostering group, and 106 (26.8%) in usual care. Compared with usual care, deprescribing was 40% more likely (relative risk [RR], 1.40; 95% CI, 1.14-1.73; absolute difference, 10.4%) in the precommitment group and 26% more likely (RR, 1.26; 95% CI, 1.01-1.57; absolute difference, 6.5%) in the boostering group. No serious adverse events were reported through the adverse event reporting system. Death rates based on manual chart review were 1.4% in the precommitment group, 3.9% in the boostering group, and 1.8% in the usual care group.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n These results support use of EHR tools designed using behavioral science principles to significantly increase rates of deprescribing potentially inappropriate medications used by older adults.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT005538065<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.26967","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T16:30:31Z","timestamp":1769704231000},"page":"1060","source":"Crossref","is-referenced-by-count":12,"title":["Electronic Health Record Intervention and Deprescribing for Older Adults"],"prefix":"10.1001","volume":"335","author":[{"given":"Julie 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