Julie C. Lauffenburger, PharmD, PhD

Effectively managing medications for older adults has become a significant challenge in health care, especially when it comes to potentially inappropriate medications (PIMs).

In light of this challenge, a new study explored whether simple nudges in electronic health records (EHRs) could enhance the deprescribing (stopping or tapering) of PIMs in older adults.

The clinical trial, led by Julie Lauffenburger, PharmD, PhD, and Niteesh Choudhry, MD, PhD, from the Division of Pharmacoepidemiology and Pharmacoeconomics at Mass General Brigham, randomized primary care physicians to receive one of two EHR prompts—one designed to promote deprescribing PIMs using behavioral science principles and one with the usual care (no prompts).  

Niteesh Choudhry, MD, PhD

The first intervention, “precommitment,” involved sending an EHR message to physicians during the first patient visit, encouraging them to discuss the potential risks of continuing certain medications.
A follow-up reminder was sent during the second visit to reinforce this discussion. In the second intervention, “boostering,” physicians were sent the same message at the first patient visit, but the follow-up reminder came four weeks later. 

They found that both approaches effectively prompted physicians to initiate deprescribing with eligible patients aged 65 or older. Compared to usual care, deprescribing was 40% more likely in the precommitment group and 26% more likely in the boostering group.

These findings showcase the potential role of behavioral science-based EHR tools in desprescribing high-risk medications on older adults’ medication lists. 

Published in JAMA on January 29, 2026| Read the paper

Summary reviewed by: Julie Lauffenburger, PharmD, PhD, lead author