Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

INV 19-150 – HSR Study

INV 19-150
Improving medication use for older adults: VIONE program
William W Hung, MD AB MPH
James J. Peters VA Medical Center, Bronx, NY
Bronx, NY
Funding Period: October 2019 - September 2021


Older adults, particularly those with multiple chronic diseases, geriatric syndromes and complex needs, often are prescribed multiple medications. They are at risk for adverse drug events stemming from complex medication use, which can result in acute care utilization, institutionalization and other long-term services use. In rural areas where expertise in geriatric care is often lacking, older adults are particularly at risk. Recently programs have been developed to reduce the number of medications, in a process known as “deprescribing”. This has yielded patient-level and system-level benefits, in particular, patient safety. The goal of this proposal is to disseminate widely, particularly in difficult to reach rural areas, a novel and effective deprescribing pharmacist-led program (VIONE) in order to improve medication use by deprescribing unnecessary and potential harmful medications using an established network of geriatric consultants and care teams. The aim of the planning proposal is to prepare for rigorous testing of dissemination strategies in phase two by: (1) Inviting stakeholders and key players to provide advice on the design of phase 2 proposal. (2) Planning for establishing a panel consisting of older Veterans, surrogate decision makers, caregivers, primary care and geriatrics teams in phase 2 proposal. (3) Utilize already collected information from the evaluation and implementation of GRECC Connect (Teleconsultation service) and VIONE (deprescribing clinical service) to inform the approach for phase 2 full proposal. (4) Develop and submit Phase II proposal armed with information from the planning activities in Aims 1-3 Phase 2 goals: We plan to test dissemination strategies utilizing information obtained from phase 1 activities to inform choices of strategies including tools to measure readiness for implementation, refine implementation toolkits to target barriers in local contexts, with the ultimate goal of planning and disseminating VIONE in the large network of VA medical centers and clinics serving rural Veterans. Innovation: The proposed study will advance the dissemination of an innovative program, VIONE, to improving medication use utilizing established networks. Because of the broad network through which dissemination and implementation occur, it necessitates a careful planning of implementation strategy, and tools that facilitates implementation and measures its adoption, adaptations, fidelity, reach, and effectiveness.

External Links for this Project

NIH Reporter

Grant Number: I01HX002905-01

Dimensions for VA

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

Learn more about Dimensions for VA.

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
    Search Dimensions for this project


Journal Articles

  1. Winter SG, Sedgwick C, Wallace-Lacey A, Dickerson K, Battar S, Hung W. Informatics Tools in Deprescribing and Medication Optimization in Older Adults: Development and Dissemination of VIONE Methodology in a High Reliability Organization. Clinical therapeutics. 2023 Sep 8. [view]

DRA: Mental, Cognitive and Behavioral Disorders, Aging, Older Veterans' Health and Care, Health Systems
DRE: TRL - Applied/Translational
Keywords: Best Practices, Medication Management, Practice Patterns/Trends
MeSH Terms: None at this time.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.