February 2, 2026
A recent publication from an IMPACT Collaboratory demonstration project by Michael Parchman, MD, MPH, Lorella Palazzo, PhD and team examines how clinical champions lead deprescribing efforts for people living with dementia within accountable care organization (ACO) primary care settings. The results, published in the Journal of General Internal Medicine, reflect how contextual factors influence the feasibility and sustainability of de-implementing potentially inappropriate medications (PIMs).
Embedded within a pragmatic cluster-randomized clinical trial conducted in ACO primary care practices, the qualitative study drew on transcripts from monthly learning calls and semi-structured interviews with 11 clinician champions. Guided by the de-implementation outcomes framework, the researchers conducted thematic analysis to better understand champions’ experiences and identify contextual factors shaping their deprescribing projects.
The findings suggest that while clinician champions can catalyze deprescribing initiatives, sustained success requires supportive organizational structures, accessible clinical data, and multidisciplinary collaboration. Interventions aligned with value-based care principles may strengthen system-level coordination and promote safer medication management for persons with dementia.
Access the full journal article, titled “Champion-Led Deprescribing for Persons with Dementia in Primary Care: A Qualitative Study in Accountable Care Organizations,” in the Journal of General Internal Medicine.