The U.S. Deprescribing Research Network

MODIFIED PROJECT SUMMARY/ABSTRACT SECTION Deprescribing is an essential component of safe and effective health care for older adults, with particular relevance to older adults with vulnerabilities such as multimorbidity and Alzheimer’s disease and related dementias (ADRD) that place them at high risk of adverse consequences from unnecessary, harmful, and goal-discordant medication use. Yet, deprescribing is much easier said than done. There is a paucity of research about how to safely and effectively stop medications among older adults, including those with ADRD and other forms of vulnerability, and the medical research paradigm is based on testing and implementing new treatments rather than the removal of treatments. Supplementing the existing paradigm with a new way of thinking requires new methods, new collaborations, and a new generation of investigators. To address this challenge, in 2019 NIA funded the U.S. Deprescribing Research Network (USDeN), a national research network whose mission is to expand the quality, quantity, and translational impact of research on deprescribing for older adults, particularly those with heightened vulnerabilities such as ADRD and multimorbidity. To date, USDeN has been remarkably successful. Educational and community-building programs have engaged hundreds of interprofessional investigators in collaborative research. Multiple pilot research projects have catalyzed new scholarship and future grant-supported research, particularly in populations with dementia, multimorbidity, and other vulnerabilities. Working groups and a data harmonization initiative have developed resources and established evidence-based best practices on foundational topics in deprescribing science. Yet, much essential work remains to be done. This proposal seeks to fund the next phase of the US Deprescribing Research Network, extending our past successes and launching new initiatives that will advance the field. Through a series of cores and programs, we seek to grow and support a national community of deprescribing investigators, aid early-career researchers with a special focus on helping them obtain grants to advance their deprescribing science and careers, advance high-priority science through targeted pilot awards and projects, and do this all with input from key stakeholders and special attention to older adults with ADRD and other forms of heightened vulnerability. Our aims are to: (1) Grow and support a national, interprofessional community of researchers focused on deprescribing for older adults, with particular focus on those with heightened vulnerability such as ADRD; (2) Enhance the research and career development of early-career investigators in deprescribing science; (3) Support high-value research initiatives including pilot grants and projects that will advance deprescribing science; and (4) Engage stakeholders and partner organizations to maximize the relevance, sustainability, and translational potential of deprescribing research. Together, these activities will advance the science and translational impact of deprescribing in older adults while elevating the career development of investigators who will lead the next generation of scholarship in this field.