# A Novel Deprescribing Intervention for Heart Failure with Preserved Ejection Fraction (HFpEF): A Prototype for Older Adults with Multimorbidity and Polypharmacy

> **NIH NIH K76** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $229,668

## Abstract

PROJECT SUMMARY
Candidate: My career goal is to improve the wellbeing of older adults with multiple chronic conditions and
polypharmacy by developing and rigorously testing rational strategies to improve medication prescribing
practices; and to become an independent clinician investigator and national leader in Geriatric Cardiology. This
area is particularly relevant for me as a heart failure cardiologist, as I care for older adults who almost
universally have multiple chronic conditions and polypharmacy. My track record as an emerging leader in this
area is evidenced by multiple lead- and senior-author manuscripts, 4 grants as the Principal Investigator
including a GEMSSTAR, my position as the Founding Director of the Weill Cornell Heart Failure with
Preserved Ejection (HFpEF) Program for the Aging, and my role as the Chair of the American College of
Cardiology Geriatric Cardiology Section Early Career Professionals Working Group. Mentors and Environment:
This project will be conducted under the mentorship of 4 well-funded investigators who will contribute their
complementary expertise in Geriatrics (Mark Lachs), Geriatric Cardiology (Mathew Maurer),
Implementation Science (Monika Safford), and N-of-1 trials (Ian Kronish). Advisors in deprescribing, shared
decision making, and biostatistics will provide additional content expertise to ensure the success of the
proposed project and catalyze my career development. This project will take place within the supportive
environment of Weill Cornell Medicine, which has demonstrated a deep commitment to my development as a
clinician-investigator for the past several years. Mentored Research Project: Despite its role as an integral part
of patient-centric and goal-concordant prescribing practice, deprescribing is seldom incorporated into clinical
practice due to several barriers. To improve patient-centered medication management, there is a need to
develop processes that can overcome these barriers. The objective of this proposal is to determine whether N-
of-1 trials—as a pragmatic patient-centered approach to medication optimization that can overcome key
barriers of deprescribing— can lead to increased patient confidence regarding the decision to continue or
discontinue a medication. To achieve this, I will: 1) determine key features of a feasible and pragmatic protocol
for deprescribing N-of-1 trials using a stakeholder-engaged iterative design approach; and 2) determine the
preliminary effectiveness of an adapted N-of-1 protocol on patient decision confidence and deprescribing, and
3) determine the facilitators and barriers of implementing an adapted N-of-1 protocol into real-world clinical
practice by conducting a type-1 hybrid effectiveness-implementation trial. I will achieve these aims by using ß-
blocker in heart failure with preserved ejection fraction (HFpEF) as a prototype for older adults with
multimorbidity and polypharmacy. This proposal will inform a future multicenter randomized controlled...

## Key facts

- **NIH application ID:** 10433979
- **Project number:** 5K76AG064428-03
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** PARAG GOYAL
- **Activity code:** K76 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $229,668
- **Award type:** 5
- **Project period:** 2020-08-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10433979

## Citation

> US National Institutes of Health, RePORTER application 10433979, A Novel Deprescribing Intervention for Heart Failure with Preserved Ejection Fraction (HFpEF): A Prototype for Older Adults with Multimorbidity and Polypharmacy (5K76AG064428-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10433979. Licensed CC0.

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