Community Based Participatory Research (CBPR) to develop a Deprescribing Intervention

Context: Older adults are at high risk for medication harm from polypharmacy and potentially inappropriate medications. Patient-driven deprescribing is an emerging approach aimed at increasing patient knowledge and strengthening self-advocacy skills. We used Community Based Participatory Research (CBPR) to engage stakeholders in developing an educational intervention on patient-driven deprescribing.

Objective: To integrate participants into research design by presenting materials and eliciting feedback to better inform a patient-driven deprescribing intervention and its implementation in primary care.

Study Design and Analysis: The stakeholders pilot-tested the research materials (letters, consent form, brochures, survey tool) on paper or online and participated in semi-structured interviews to elicit feedback.

Setting: Western New York.

Population Studied: Elder Voices, an active group of older adults who had previously participated in developing the educational materials. N =7 (4 paper; 3 online).

Instrument: The semi-structured interview was developed based on cognitive interviewing to ensure that the stakeholders interpreted the research materials and survey questions correctly.

Outcome Measures: Qualitative data to inform the research intervention.

Results: Participants suggested lay language and clarification of terms in the survey and brochures and insertion of additional graphics and visualizations for reader engagement. The interviewees were concerned about the length and use of academic language in the letters, consent form, and surveys. They also cited lack of technological capacity for some older adults to access the online intervention tool. Modifications to the research materials were incorporated within the parameters of institutional requirements and finalized for use in a primary care practice.

Conclusions: The CBPR process with Elder Voices informed the design of the educational intervention and research materials. The study contributes to deprescribing research as an example of how CBPR may be used to engage older adults in developing a deprescribing study. Including stakeholders in the research design provides an equitable voice to those impacted by the intervention. Further, it provides insight to the research team on how to better equip patients with the correct knowledge and tools to become empowered participants in their healthcare decisions.