Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.
J Clin Epidemiol. 2020 Mar;119:65-74. doi: 10.1016/j.jclinepi.2019.11.013. Epub 2019 Nov 29.
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.
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.
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.
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.
停止使用不适当的药物已被广泛认为是最佳处方实践的重要组成部分。医生通常根据临床经验尝试逐渐减少或停止药物治疗，而不是采用循证指导的系统方法。我们试图评估在初级保健中进行的药物停用试验的报告质量和详细程度是否足以在临床实践中进行复制。
本研究是对 2018 年发表的一项系统评价数据的二次分析，该评价调查了在初级保健中停止使用慢性药物的效果。纳入了 26 篇报告 27 项试验的出版物。使用干预描述和复制模板（TIDieR）检查表评估报告质量。
没有研究在所有 TIDieR 项目上提供完整的报告。所有研究都对干预措施进行了明确的描述和论证；然而，大多数研究对干预措施的细节报告不足，研究之间存在很大的差异。查阅次要来源仅获得了很少的额外信息。
初级保健中药物停用干预措施的报告方法细节存在明显缺陷。基于证据的药物停用可能没有像应该的那样常规地应用于医疗保健实践。提高干预措施报告的质量对于避免研究资源的浪费至关重要，应该成为所有停药试验的重点。
