{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:18:34Z","timestamp":1782505114311,"version":"3.54.5"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T00:00:00Z","timestamp":1548028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG044440"],"award-info":[{"award-number":["K23AG044440"]}],"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":["K23AG043476"],"award-info":[{"award-number":["K23AG043476"]}],"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":["R01AG034205"],"award-info":[{"award-number":["R01AG034205"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Benzodiazepines and anticholinergics are risk factors for delirium in the intensive care unit (ICU). We tested the impact of a deprescribing intervention on short\u2010term delirium outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multisite randomized clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>ICUs of three large hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Two hundred adults aged 18 years or older and admitted to an ICU with delirium, according to the Richmond Agitation\u2010Sedation Scale and the Confusion Assessment Method for the ICU (CAM\u2010ICU). Participants had a contraindication to haloperidol (seizure disorder or prolonged QT interval) or preference against haloperidol as a treatment for delirium, and were excluded for serious mental illness, stroke, pregnancy, or alcohol withdrawal. Participants were randomized to a deprescribing intervention or usual care. The intervention included electronic alerts combined with pharmacist support to deprescribe anticholinergics and benzodiazepines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcomes were delirium duration measured by the CAM\u2010ICU and severity measured by the Delirium Rating Scale Revised\u201098 (DRS\u2010R\u201098) and the CAM\u2010ICU\u20107; secondary outcomes included adverse events and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants had a mean age of 61.8 (SD = 14.3) years, 59% were female, and 52% were African American, with no significant differences in baseline characteristics between groups. No differences between groups were identified in the number exposed to anticholinergics (\n                      <jats:italic>P<\/jats:italic>\n                      = .219) or benzodiazepines (\n                      <jats:italic>P<\/jats:italic>\n                      = .566), the median total anticholinergic score (\n                      <jats:italic>P<\/jats:italic>\n                      = .282), or the median total benzodiazepine dose in lorazepam equivalents (\n                      <jats:italic>P<\/jats:italic>\n                      = .501). Neither median delirium\/coma\u2010free days (\n                      <jats:italic>P<\/jats:italic>\n                      = .361) nor median change in delirium severity scores (\n                      <jats:italic>P<\/jats:italic>\n                      = .582 for DRS\u2010R\u201098;\n                      <jats:italic>P<\/jats:italic>\n                      = .333 for CAM\u2010ICU\u20107) were different between groups. No differences in adverse events or mortality were identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When added to state\u2010of\u2010the\u2010art clinical services, this deprescribing intervention had no impact on medication use in ICU participants. Given the age of the population, results of clinical outcomes may not be easily extrapolated to older adults. Nonetheless, improved approaches for deprescribing or preventing anticholinergics and benzodiazepines should be developed to determine the impact on delirium outcomes. J Am Geriatr Soc 67:695\u2013702, 2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15751","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T10:05:15Z","timestamp":1548065115000},"page":"695-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8933-9339","authenticated-orcid":false,"given":"Noll L.","family":"Campbell","sequence":"first","affiliation":[{"name":"Purdue University College of Pharmacy  West Lafayette Indiana"},{"name":"Indiana University Center for Aging Research  Indianapolis Indiana"},{"name":"Regenstrief Institute, Inc  Indianapolis Indiana"},{"name":"Indiana University Center for Health Innovation and Implementation Science and Indiana Clinical and Translational Sciences Institute  Indianapolis Indiana"},{"name":"Sandra Eskenazi Center for Brain Care Innovation at Eskenazi Health  Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Indiana University Center for Health Innovation and Implementation Science and Indiana Clinical and Translational Sciences Institute  Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4507-6968","authenticated-orcid":false,"given":"Babar A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Indiana University Center for Aging Research  Indianapolis Indiana"},{"name":"Regenstrief Institute, Inc  Indianapolis Indiana"},{"name":"Indiana University Center for Health Innovation and Implementation Science and Indiana Clinical and Translational Sciences Institute  Indianapolis Indiana"},{"name":"Sandra Eskenazi Center 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