Instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing: a scoping review protocol

BMJ Open, Journal Year: 2025, Volume and Issue: 15(1), P. e095584 - e095584

Published: Jan. 1, 2025

Objective To map instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing. Introduction Deprescribing is essential improving patient outcomes by managing polypharmacy, reducing fall risks decreasing medication costs. However, there a limited exploration of perspectives about Methods analysis Studies involving professionals directly involved in the use process (nurses, pharmacists physicians) will be included, while those which it not possible to identify professional excluded. Any definition deprescribing, as well any stage deprescribing process, without clear employing whether validated or not, included. focusing on algorithms setting Data presented absolute relative frequencies, world heatmap, heatmaps, bar plots word cloud when appropriate. Ethics dissemination The findings from this review discussed with stakeholders processes. Additionally, results disseminated through publications conference presentations. Protocol registration https://osf.io/tgjyc/

Language: Английский

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Enablers and barriers to community pharmacists’ readiness to implement deprescribing of inappropriate medications for older adults in Qatar

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(1), P. e0316363 - e0316363

Published: Jan. 30, 2025

There is paucity of studies focused on the enablers and barriers to community pharmacists’ readiness deprescribe inappropriate medications for older adults in developing settings. The current study assessed implement deprescribing adults. A cross-sectional survey 252 pharmacists was conducted Qatar with a pre-tested 24-item questionnaire developed theory domain framework. Information about perceived were elicited 5-point Likert-type scale. response rate 79.4% (200/252). majority females (54.5%), within age range 20–40 years (88.0%), had BSc / BPharm as highest educational qualification (70.5%), full-time employee (97.0%). top-ranked exposure CPD use toolkits algorithm (66%), interprofessional collaboration physicians (60.5%) shared electronic patient record (59.5%), improved remuneration re-imbursement 58%). lack access records ineffective (66.5%), time due heavy workload (65%), regulatory framework that limit expansion clinical roles (51%) intense focus sales target (49%). algorithm, record. These findings bode well implementation pharmacists-led Qatar. However, number critical identified, these will require institutional, organizational interventions improve readiness.

Language: Английский

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Deprescribing NSAIDs: The Potential Role of Community Pharmacists

Pharmacy, Journal Year: 2024, Volume and Issue: 12(4), P. 116 - 116

Published: July 24, 2024

Non-steroidal anti-inflammatory drugs (NSAIDs) are largely used for controlling various pain conditions and widely available in community pharmacies, with without prescription. Despite their effectiveness, NSAIDs can pose significant risks due to potential side effects drug interactions, particularly polypharmacy comorbidity contexts vulnerable users. This study investigated whether how deprescribing be conducted at the pharmacy level by assessing pharmacists' confidence, attitudes, barriers facilitators. Additionally, we aimed identify any guidelines that pharmacists could use. A literature search a cross-sectional digital questionnaire targeting Norway were conducted. Results showed participants (N = 73) feel confident identifying needs but such as time constraints, lack of financial compensation, communication challenges noted. Participants reported positive attitudes toward highlighted need better training. highlights gap specific enhancing roles process, example, through training improved incentives. Further research is encouraged develop concrete strategies an effective implementation where involved NSAIDs.

Language: Английский

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Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey

European Geriatric Medicine, Journal Year: 2022, Volume and Issue: 13(6), P. 1455 - 1466

Published: Nov. 2, 2022

To provide an overview of the current deprescribing attitudes, practices, and approaches geriatricians geriatricians-in-training across Europe.An online survey was disseminated among European geriatricians-in-training. The comprised Likert scale multiple-choice questions on education knowledge, facilitators/barriers deprescribing. Responses to participant characteristics were quantified differences evaluated between regions.The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) generally willing deprescribe (98%) felt confident about (85%). Despite regions, most commonly reported reasons for functional impairment occurrence adverse drug reactions. important barriers patients' unwillingness, fear negative consequences, lack time, poor communication multiple prescribers. Perceived risk reactions highest psychotropic drugs, nonsteroidal anti-inflammatory cardiovascular opioid analgesics. Only one in four (23% 37% think medical school had sufficiently prepared them clinical practice. They that their future activities would probably increase with improved information sharing various prescribers, recommendations guidelines, increased training. Approximately 90% a paradigm shift is required prescribers patients, increasing focus possible benefits (potentially) inappropriate medications.Based outcomes this survey, we recommend investing inter-professional communication, better evidence-based improve patient-centered practices.

Language: Английский

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Are pharmacists’ knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes

International Journal of Pharmacy Practice, Journal Year: 2023, Volume and Issue: 31(4), P. 387 - 395

Published: April 28, 2023

Deprescribing is a novel strategy whereby medical professionals aim to optimize patient's prescription program by removing redundant medications. Few studies have looked at the viewpoints of community pharmacists and other healthcare on deprescribing in daily practice. This study's objectives included evaluating pharmacists' knowledge, attitudes practices, as well identifying obstacles enablers practice.Five pharmacy students last year their polled employees neighbourhood pharmacies Abu Dhabi, Dubai, Northern Emirates from April 2022 July 2022. The questionnaire was divided into two sections: questions that inquired about respondents' demographic data evaluated understanding usage potentially harmful medications for patients. original Bloom's cutoff points were revised modified assess general knowledge practices United Arab (UAE) pharmacists. Multivariate logistic regression identified variables influencing practice.The average age participants 30.8 ± 6.4 SD. Of total, 255 (37.7%) male 422 (62.3%) female. Pharmacists independent constituted 52.9% study sample 47.1% Chain pharmacies. Among participants, 58.8% (n = 398) had 1-5 years experience 41.2% 279) more than 5 years. Nearly three-quarters (72.1%, 488) graduated local universities 27.9% 189) regional/international universities. vast majority (84.8%, 574) bachelor's degree holders 88.3% 598) charge. 69.3% 469) received training treat patients with multimorbid diseases. practice score 71.3% 95% confidence interval [70.2%, 72.4%]. total 113 (16.7%) poor deprescribing, 393 (58.1%) moderate 171 (25.3%) good practice.This highlights level UAE. Although most respondents this less half unaware certain classes (long-acting sulfonylureas, anti-diabetic, antihyperlipidemic psychotropic drugs) drugs are candidates potential deprescribing. finding indicates insufficient. Several barriers face also identified, patients' resistance insufficience being prevalent. Therefore, there need improved ensure drug safety.

Language: Английский

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Barriers and enablers to deprescribing in long-term care: A qualitative investigation into the opinions of healthcare professionals in Ireland

PLoS ONE, Journal Year: 2022, Volume and Issue: 17(12), P. e0274552 - e0274552

Published: Dec. 15, 2022

The prevalence of polypharmacy increases with age, increasing the exposure older adults to potentially inappropriate medications (PIMs). Deprescribing has been shown reduce PIMs for residents in long-term care; however, deprescribing is not universally implemented. This study aims identify barriers and enablers Irish care facilities from healthcare professionals' (HCPs) perspective.A qualitative descriptive approach was conducted using semi-structured interviews HCPs working (general practitioners, pharmacists nurses). Purposive sampling maximum variation applied select sites HCPs, supplemented convenience post-graduate University College Cork. Data thematically analysed mapped a framework informed by Theoretical Domains Framework.Twenty-six participated 13 facilities. main identified five domains. Barriers included insufficient resources, lack co-ordination between settings negative social influences. Additional exist private including awareness, commitment need incentives. interprofessional support patient influence. To encourage deprescribing, potential include HCP education, pharmacist role expansion tailored guidelines within structured process.Interventions should build on existing systems, involve stakeholders utilise process. Any intervention must account nuanced which both public settings.

Language: Английский

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Multidisciplinary DEprescribing review for Frail oldER adults in long-term care (DEFERAL): Implementation strategy design using behaviour science tools and stakeholder engagement

Research in Social and Administrative Pharmacy, Journal Year: 2023, Volume and Issue: 19(8), P. 1202 - 1213

Published: May 12, 2023

Deprescribing is a strategy for reducing the use of potentially inappropriate medications older adults. Limited evidence exists on development strategies to support healthcare professionals (HCPs) deprescribing frail adults in long-term care (LTC). To design an implementation strategy, informed by theory, behavioural science and consensus from HCPs, which facilitates LTC. This study was consisted 3 phases. First, factors influencing LTC were mapped behaviour change techniques (BCTs) using Behaviour Change Wheel two published BCT taxonomies. Second, Delphi survey purposively sampled HCPs (general practitioners, pharmacists, nurses, geriatricians psychiatrists) conducted select feasible BCTs deprescribing. The rounds. Using results literature used effective interventions, could form shortlisted research team based acceptability, practicability effectiveness. Finally, roundtable discussion held with purposeful, convenience sample general pharmacists nurses prioritise tailor proposed Factors 34 BCTs. completed 16 participants. Participants reached that 26 feasible. Following assessment, 21 included roundtable. identified lack resources as primary barrier address. agreed incorporated 11 education-enhanced 3-monthly multidisciplinary review, led nurse, at site. incorporates HCPs' experiential understanding nuances thus addresses systemic barriers this context. designed five determinants best engaging

Language: Английский

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Gyógyszerrosta: a racionális gyógyszeres terápia meghatározó eleme

Orvosi Hetilap, Journal Year: 2023, Volume and Issue: 164(24), P. 931 - 941

Published: June 18, 2023

A gyógyszerrosta (az angol deprescribing magyar megfelelője) tervezett, szisztematikus gyógyszerleépítési folyamat, amely egészségügyi szakember felügyeletével zajlik, és lényegében a helyes gyógyszerrendelési gyakorlat részének tekintendő. nemcsak teljes gyógyszerelhagyást jelentheti, hanem dóziscsökkentés folyamata is lehet. Megtervezése során létfontosságú figyelembe venni terápiás célkitűzéseket, valamint beteg egészségi állapotát, időbeli életkilátását, értékrendjét igényeit. célja betegenként változhat, alapvetően azonban prioritásnak tekinthető számára fontos célok elérése, életminőségének javítása. Közleményünkben nemzetközi szakirodalom alapján áttekintjük folyamatának lehetséges célpontjait: azokat nagy kockázatú betegcsoportokat, amelyeknél előnyös lehet gyógyszerleépítés; gyógyszereket gyógyszercsoportokat, amelyek szedése esetén szükség terápia felülvizsgálatára; összefoglaljuk folyamat színtereit. Ezenkívül kitérünk általános lépéseire, előnyeire, kockázataira, ismertetjük rendelkezésre álló specifikus irányelveket, algoritmusokat. Részletesen tárgyaljuk folyamatot segítő hátráltató tényezőket, mind az szakemberek, pedig betegek szemszögéből, végül kezdeményezésekre jövőjére is. Orv Hetil. 2023; 164(24): 931–941.

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Pharmacists’ attitudes towards interprofessional collaboration to optimise medication use in older patients in Switzerland: a survey study

BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)

Published: July 26, 2024

Abstract Background Collaboration between physicians and pharmacists facilitates the conduct of medication optimisation efforts. In context deprescribing, pharmacists’ roles are often described as making deprescribing recommendations to physicians. Little is known about factors associated with willingness make their interprofessional collaboration in Swiss primary care settings. Objective To explore pharmacists' perspectives on older adults, preferences for Methods this cross-sectional study, a random sample 1000 pharmacist members Pharmacists Association pharmaSuisse was invited participate survey optimisation, collaboration. The contained three case vignettes multimorbid patients polypharmacy aged ≥ 80 years old, different levels dependency activities daily living (ADL) cardiovascular disease (CVD). For each vignette, were asked if which medications they would deprescribe. We calculated proportions deprescribe by vignette performed multilevel logistic regression assess associations CVD, ADL, Results One hundred thirty-eight (14%) responded survey: 113 (82%) female, mean age 44 ( SD = 11), 66% n 77) reported having never received any specific training how structured reviews. Eighty-three (72%) be confident identifying opportunities. All willing 1 all vignettes. Patients CVD at lower odds deprescribed (OR 0.27, 95%CI 0.21 0.36). Willingness higher ADL (medium versus low dependency: OR 0.68, 0.54 0.87, high 0.72, 0.56 0.91). However, effect significantly modified history CVD. five (97%) interact clarify questions regarding prescriptions least once week 88 (81%) wished more involved review. Conclusion suggestions polypharmacy, but two-thirds no formal perform like process review should leveraged

Language: Английский

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Identification of Potentially Inappropriate Medications in Frail Older Adults Residing in Long-Term Care: A Retrospective Chart Review Study

Drugs - Real World Outcomes, Journal Year: 2022, Volume and Issue: 10(1), P. 97 - 106

Published: Nov. 27, 2022

Deprescribing is associated with positive health outcomes for older adults in long-term care (LTC), however deprescribing not universally implemented. The primary aim of this study was to estimate the prevalence potentially inappropriate medications (PIMs) prescribed frail Irish facilities (LTCFs), as identified by Screening Tool Older Persons Prescriptions Frail limited life expectancy, version 2 (STOPPFrail v2). A retrospective chart review conducted two publicly funded LTCFs Ireland. Eligible participants were those (1) ≥ 65 years age; (2) resident a LTCF; (3) eligible per STOPPFrail v2 criteria site's Medical Officer; and (4) receiving regular medication. Data collected included age, sex, drug, dose, frequency, regular/pro re nata prescribing indication/relevant diagnoses. Rates polypharmacy (taking five or more medications) excessive 10 calculated. used identify PIMs; however, clinical measurements taken. Descriptive association statistics Of 103 residents, 89 age categorised therefore inclusion study. eligible, 85 (95.5%) had 57 (64%) experienced polypharmacy. mean number 10.8 (± 3.8), total 17.7 5) diagnoses 5.5 2.5). PIMs 4.8 2.6). participants, 59.6% at least one medicine without documented indication, while 61.8%, 42.7% 30.3% PIM from vitamin D, antihypertensives proton pump inhibitors drug classes, respectively. Medication use high among LTC concern. Lack clear indication appears be an issue LTC, affecting healthcare professionals' engagement deprescribing. may overestimated antihypertensives/antidiabetic classes due lack measurements.

Language: Английский

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