{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:24:39Z","timestamp":1791246279326,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03AG089044"],"award-info":[{"award-number":["R03AG089044"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG058926"],"award-info":[{"award-number":["R33AG058926"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T35\u2010DK007386"],"award-info":[{"award-number":["T35\u2010DK007386"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients and experts agree that potentially inappropriate medications should be reconsidered after adverse drug events (ADEs), yet emergency providers are often hesitant to discuss deprescribing in deference to outpatient prescribers. We sought to explore patient communication preferences for deprescribing in the emergency department (ED) after an ADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional survey study of older adults aged 65\u2009years and older presenting to a southeastern, academic ED from June 2024 to October 2024. While awaiting results, eligible participants completed a best\u2010worst scaling survey comparing seven potential ED communication strategies for prompting deprescription of daily aspirin. The primary analysis tested whether an ED\u2010initiated \u201ctherapeutic pause\u201d (\u201cConsidering your bleeding, I would like you to hold your aspirin until you can discuss with your primary care provider\u201d) was preferred by &gt;\u200950% of participants over a generic discharge referral to a primary care provider through a one\u2010sided binomial test. Secondary analyses used conditional logistic regression to evaluate relative preference across all seven deprescribing phrases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 102 patients completed the survey with a mean (SD) age of 75\u2009years old (std dev 7). Among all respondents, 62% (95% CI, 52%\u201371%) preferred an ED\u2010initiated \u2018therapeutic pause\u2019 of aspirin with primary care follow\u2010up to the generic PCP deferral approach (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). The least preferred statement was a strict deprescribing recommendation (\u201cI do not think you need aspirin anymore\u201d), which was selected as the least\u2010favored communication approach in 65% of choice tasks. In conditional logistic regression, the therapeutic pause had greater odds of being selected as most preferred compared to the least preferred phrase (OR 9.3; 95% CI, 6.3\u201313.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study suggests that ED physicians may take a proactive approach in addressing potential deprescribing in caring for patients with ADEs, such as initiating a therapeutic pause of aspirin after an episode of bleeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70287","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:16:08Z","timestamp":1776093368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Navigating Medication Risk in the\n                    <scp>ED<\/scp>\n                    : Communication Preferences of Older Adults Regarding Deprescribing"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2968-4114","authenticated-orcid":false,"given":"Grace","family":"Burud","sequence":"first","affiliation":[{"name":"University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Lopes","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smeet","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-3737","authenticated-orcid":false,"given":"Parag","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Niznik","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill, School of Medicine  Chapel Hill North Carolina USA"},{"name":"Division of Pharmaceutical Outcomes and Policy University of North Carolina at Chapel Hill, Eshelman School of Pharmacy  Chapel Hill North Carolina USA"},{"name":"Center for Health Equity Research and Promotion Veterans Affairs (VA) Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Donvan","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Dodson","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Musgrow","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Anton","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of North Carolina Medical Center  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ula","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine New York University Grossman School of Medicine  New York New York USA"},{"name":"Geriatrics Research, Education and Clinical Center (GRECC), James J. Peters VAMC  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5049-012X","authenticated-orcid":false,"given":"Martin F.","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13844"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.4720"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-75888-8"},{"issue":"6","key":"e_1_2_10_5_1","article-title":"Deprescribing in Real Time: Hospitalized Septuagenarian With Polypharmacy","volume":"15","author":"Famuyiro T.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2023.04.008"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2007.12.002"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0621-2"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40360-019-0297-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.009"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.70127"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2023.08.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18047"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13886"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181ef9a7e"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.32"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S118836"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.2633"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07828-3"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-024-01179-w"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06063-y"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.70287","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.70287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:02:26Z","timestamp":1777438946000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.70287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/acem.70287"],"URL":"https:\/\/doi.org\/10.1111\/acem.70287","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70287"}}