Participant eligibility within clinic
opioid use disorder, dementia
BLIND, PCP, METASTATIC CANCER
The study participant sample for each intervention and usual care matched clinic pair is identified at the time the intervention is implemented at the intervention clinic. For opioid and sedative-hypnotic medications, eligible participants are aged 60 years or older, while for skeletal muscle relaxants, tricyclic antidepressants, and first-generation antihistamines, eligible participants are aged 65 years or older. Eligible participants must be long-term users of the target medication, defined as pharmacy dispensing of at least one of the target medication classes for at least 70 of the prior 90 days. Further, eligible participants must either be assigned to a primary care provider (PCP) or have had 1 + visits in the prior year with a PCP at one of the 18 KPWA clinics participating in the study. Once a participant is determined as having received care or having a PCP at a given clinic, their clinic assignment is fixed, and therefore their randomization assignment will be static throughout the study.Individuals will be excluded for any one of the following reasons, all ascertained pragmatically (i.e., from electronic data sources): (a) diagnosis of dementia or a prescription for a medication used to treat dementia (i.e., a cholinesterase inhibitor or memantine); (b) residence in a skilled nursing facility; (c) metastatic cancer diagnosis in the prior 12 months; (d) receiving hospice or palliative care; (e) legally blind (unable to read print materials); (f) indication the participant requires a translator (cannot read materials printed in English); (g) enrolled in other KPWA opioid deprescribing research studies; (h) enrolled in a KPWA pharmacy-driven initiative to reduce opioid dose; or (i) diagnosed with opioid use disorder.