#3-40E. Nudging Physicians to Deprescribe: Behavioral Science in the EHR (JAMA, 2026)

Prescribing potentially inappropriate medications to older adults is a pervasive issue, yet deprescribing remains difficult in routine practice due to clinical inertia and time constraints. In this episode, we examine a randomized clinical trial by Lauffenburger et al. that evaluated two behavioral science-informed electronic health record (EHR) interventions—precommitment and boostering—designed to facilitate the deprescribing of benzodiazepines, sedative hypnotics, and anticholinergics in primary care. The study's most significant finding was that the "precommitment" intervention, which prompted physicians to initiate discussions via specific notifications, increased deprescribing rates by an absolute difference of 10.4% compared with usual care. While this suggests that automated "nudges" can effectively trigger necessary clinical actions, critical appraisal reveals that despite higher deprescribing events, the interventions did not significantly reduce the cumulative dosage or total pill quantity prescribed. For our physician listeners, this study highlights the potential of EHR tools to overcome barriers to initiating deprescribing conversations, while also signaling that such tools may need to be paired with sustained management strategies to achieve meaningful reductions in overall drug burden.

Citation: Lauffenburger JC, Sung M, Glynn RJ, et al. Electronic Health Record Intervention and Deprescribing for Older Adults A Randomized Clinical Trial. JAMA. 2026. DOI: 10.1001/jama.2025.26967

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.