Yes, indeed what I am thinking of is deliberate de-implementation strategies…aside of some retrospective studies (done to demonstrate after-the-fact change in practice) it seems that there are more methodological and white-paper statements then actual prospective,  deliberate de-implementation strategies…Now, a number of people sent me some interesting papers, so this impression may change after I review all contributions (probably in about 2 weeks); so, if anyone is aware of an example of deliberate, prospective de-implementation of any medical interventions, please send it along

Thanks

ben

 

From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Bewley, Susan
Sent: Thursday, January 23, 2020 3:14 PM
To: [log in to unmask]
Subject: Examples of successful de-implementation strategies....

 

Are you thinking of deliberate de-implementation or things that have fallen by the wayside (for whatever reason)

 

It would be wonderful to have a set of 'rules' for de-implementation if they are not already devised (maybe especially of screening - because the  prevalence fell with another strategy or treatments became so much better the benefit:harm ratio changed). Telling the population in advance that all screening programmes are temporary might be a start. We used to XR loads of populations for TB (till it went away... only to return), we stopped thyroid cancer screening, we need to wean populations off breast screening etc.

 

 

Susan Bewley  MA MD FRCOG

 

Professor (emeritus) of Obstetrics and Women's Health

c/o Department of Women and Children's Health

School of Life Course Sciences

King's College London

10th Floor, North Wing
St. Thomas' Hospital
Westminster Bridge Road
LONDON SE1 7EH

Tel: 020 7188 3639

Mob 07984 907 548

https://en.wikipedia.org/wiki/Susan_Bewley

P Please consider the environment before printing this e-mail!

 

From: Evidence based health (EBH) <[log in to unmask]> on behalf of Bill Cayley, Jr <[log in to unmask]>
Sent: 17 January 2020 22:27
To: [log in to unmask] <[log in to unmask]>
Subject: Re: Examples of successful de-implementation strategies....

 

This may not be directly what you were looking for, but is at least tangentially related - 

 

Maund E, Stuart B, Moore M, Dowrick C, Geraghty AWA, Dawson S, Kendrick T.
Managing Antidepressant Discontinuation: A Systematic Review. Ann Fam Med. 2019
Jan;17(1):52-60. doi: 10.1370/afm.2336

 

Bill Cayley, Jr, MD MDiv  

Work: 715.286.2270

Pager: 715.838.7940

Mobile: 715.828.4636

 

A cheerful heart is good medicine...  (Proverbs 17:22)

 

 

On Thursday, January 16, 2020, 08:05:49 PM CST, Benjamin Djulbegovic MD <[log in to unmask]> wrote:

 

 

Dear all,

 

For all discussion about waste, overRx etc, there appears to be paucity of successful de-implementation examples. I would appreciate it if you can send me the examples of successful de-implementation strategies that you are aware of. I will then compile the list and share with all.

 

Thanks

 

Ben djulbegovic 

 

Sent from my iPad - excuse typos and brevity

 

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