Unpacking the complexities of de-implementing inappropriate health interventions

Implement Sci. 2020 Jan 9;15(1):2. doi: 10.1186/s13012-019-0960-9.


De-implementing inappropriate health interventions is essential for minimizing patient harm, maximizing efficient use of resources, and improving population health. Research on de-implementation has expanded in recent years as it cuts across types of interventions, patient populations, health conditions, and delivery settings. This commentary explores unique aspects of de-implementing inappropriate interventions that differentiate it from implementing evidence-based interventions, including multi-level factors, types of action, strategies for de-implementation, outcomes, and unintended negative consequences. We highlight opportunities to continue to advance research on the de-implementation of inappropriate interventions in health care and public health.

Keywords: De-adoption; De-escalation; De-implementation; Harmful; Implementation science; Ineffective; Low-value; Medical reversal; Overscreening; Overtreatment; Overuse; Unproven.

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Delivery of Health Care / standards
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Implementation Science*
  • Medical Overuse / prevention & control
  • Organizational Culture
  • Patient Safety / standards
  • Practice Guidelines as Topic
  • Socioeconomic Factors