Diabetes Deprescribing in Older Adults: A Randomized Clinical Trial
Primary result · Diabetes medication deprescribingResult — go to the resultAdjusted risk difference 7.5% 95% CI 1.5%–13.6%Authors' conclusion
In this randomized clinical trial, AD with previsit activation was a simple and effective strategy for increasing diabetes medication deprescribing in older patients with type 2 diabetes.
Study context
- Population
- Patients aged ≥75 years with T2D, HbA1c ≤8.0%, treated with insulin and/or SU, and their primary care physicians (PCPs), large integrated health care system in Northern California; mean age 79.9 years, 49.6% female
- Participants
- 450 patients211 PCPs
- Comparison
- Physician academic detailing plus patient previsit activation vs academic detailing (AD) only
- AD plus previsitn = 232
- AD-onlyn = 218reference
- Primary endpoint
- Diabetes medication deprescribing (aggregate measure) and any patient-reported severe hypoglycaemia episodes
- Follow-up
- 6 months
Methodological detailspatient-randomised, attention control, Conducted September 2020 to March 2024, 6 and 12 months of follow-up
- Patient-randomised
- Attention control
- Conducted September 2020 to March 2024, 6 and 12 months of follow-up
Primary result
Diabetes medication deprescribing
Adjusted risk difference
7.5%
95% CI 1.5%–13.6%
P = 0.01
Events by treatment group
AD plus previsitvs AD-only
adjusted risk difference 7.5% (95% CI 1.5%–13.6%); P = 0.01
As reported in the abstract
Further findings
| Outcome | AD plus previsit | AD-only | Adjusted RD (95% CI) | P value | |
|---|---|---|---|---|---|
| Diabetes medication deprescribing · 12 months | 22.8% | 16.3% | 7.9% (0.4%–15.5%) | P = 0.04 | |
| −1001020Difference (linear scale) |
Safety
| Outcome | AD plus previsit | AD-only | Adjusted RD (95% CI) | P value | |
|---|---|---|---|---|---|
| Severe self-reported hypoglycaemia (primary outcome) · 6 monthsNot statistically significant difference, as printed | 4.7% | 6.5% | −2.3% (−7.1% to 2.5%) | P = 0.04 | |
| −10−505Difference (linear scale) |
Original publication
Diabetes Deprescribing in Older Adults: A Randomized Clinical Trial. JAMA Intern Med. Published 1 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →