Abstract Older African American women experience social determinants of health that put them at risk for experiencing comorbid pain and depressive symptoms. The purpose of our study was to tailor a preexisting evidence-based depression intervention to include pain and test it in older African American women. We conducted a randomized waitlist control study with 21 frail or pre-frail, African American women, 50 years of age and older with pain and depressive symptoms. The average age of the participants was 64.8 (SD: 10.5), average pain intensity was 7.0 (SD: 1.9) out of 10, and average PHQ-9 depressive symptoms score was11.9 (SD: 4.0). Effect sizes at 12 weeks post intervention were -1.05 for depressive symptoms indicating a substantial decrease in depressive symptoms. We did not see a significant change in pain intensity but identified changes in pain behavior scores. The women described the intervention as beneficial and provided suggestions for future iterations.

Deprescribing, the planned and supervised process of dose reductions or stopping inappropriate medications, may address increasing burdens from multimorbidity and polypharmacy, defined as the use of five or more medications. Despite its benefits in mortality, falls, and depression, current evidence lacks focus on incorporating and leveraging patients' daily goals and goals for their lives, called life goals. Home-based care, which has shown benefits in healthcare access/utilization/costs, caregiver burden, and patient satisfaction among frail, vulnerable, and homebound populations, can address this gap. Since only a few studies have focused on home-based deprescribing approaches, we aimed to understand from clinicians and older adults ways to optimize a proposed home-based deprescribing intervention that focuses on tailoring medications based on patient's daily and life goals.