Deprescribing in older adults with polypharmacy
Anna Hung,
No information about this author
Yoon Hie Kim,
No information about this author
Juliessa M. Pavon
No information about this author
et al.
BMJ,
Journal Year:
2024,
Volume and Issue:
unknown, P. e074892 - e074892
Published: May 7, 2024
Abstract
Polypharmacy
is
common
in
older
adults
and
associated
with
adverse
drug
events,
cognitive
functional
impairment,
increased
healthcare
costs,
risk
of
frailty,
falls,
hospitalizations,
mortality.
Many
barriers
exist
to
deprescribing,
but
efforts
have
been
made
develop
implement
deprescribing
interventions
that
overcome
them.
This
narrative
review
describes
intervention
components
summarizes
findings
from
published
randomized
controlled
trials
tested
polypharmacy,
as
well
reports
on
ongoing
trials,
guidelines,
resources
can
be
used
facilitate
deprescribing.
Most
were
medication
reviews
primary
care
settings,
many
contained
such
shared
decision
making
and/or
a
focus
patient
priorities,
training
for
professionals,
facing
education
materials,
involvement
family
members,
representing
great
heterogeneity
addressing
polypharmacy
adults.
Just
over
half
study
found
perform
better
than
usual
at
least
one
their
outcomes,
most
assessed
12
months
or
less.
Language: Английский
Deprescribing for nursing home residents with limited life expectancy: A qualitative study to identify barriers and enablers for healthcare professionals
Geriatric Nursing,
Journal Year:
2025,
Volume and Issue:
62, P. 1 - 11
Published: Feb. 4, 2025
Language: Английский
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
Patient-Directed Education to Promote Deprescribing
JAMA Internal Medicine,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Sept. 23, 2024
Patient-directed
educational
materials
are
a
promising
implementation
strategy
to
expand
deprescribing
reach
and
adoption,
but
little
is
known
about
the
impact
across
medication
groups
with
potentially
different
perceived
risks.
Language: Английский
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
Prevalence of strong anticholinergic use in residents with and without cognitive impairment and frailty: analysis from 106 nursing homes in 12 Asia-Pacific and European countries
Archives of Gerontology and Geriatrics,
Journal Year:
2024,
Volume and Issue:
128, P. 105636 - 105636
Published: Sept. 11, 2024
Language: Английский
Factors influencing healthcare providers’ behaviours in deprescribing: a cross-sectional study
Journal of Pharmaceutical Policy and Practice,
Journal Year:
2024,
Volume and Issue:
17(1)
Published: Sept. 16, 2024
Deprescribing
serves
as
a
pivotal
measure
to
mitigate
the
drug-related
problem
due
polypharmacy.
This
study
aimed
map
factors
influencing
healthcare
providers'
deprescribing
decision
using
Behaviour
Change
Wheel
framework
and
develop
an
innovative
conceptual
model
support
practice.
A
cross-sectional
online
survey
targeting
doctors
pharmacists
was
conducted
assess
influence
of
various
on
comfort
in
recommending
deprescribing.
The
formulated,
based
existing
Wheel.
model's
robustness
scrutinised
through
Partial
Least
Squares
Structural
Equation
Modeling
(PLS-SEM),
model-fitting
indices
were
employed
obtain
best-fit
model.
total
736
responses
analysed
with
final
consisting
24
items
5
constructs
(R
2:
0.163;
SRMR:
0.064;
rho_c:
0.750-0.862;
AVE:
0.509-0.627)
three
independent
factors.
Based
results,
we
proposed
that
could
be
promoted
strategies
at
enhancing
providers
internal
capabilities
such
knowledge
levels,
when
patients'
condition
deteriorated
previous
experiences
adverse
events
drugs.
Organisational
providing
educational
opportunities
is
important,
empowerment
patient
policy
enhancements,
guideline
development,
effective
communication.
behaviours
professionals
are
influenced
by
intricate
interplay
patient,
prescriber,
system
Enhancing
practices
necessitates
comprehensive
strategy
encompasses
education,
development
structured
guidelines,
implementation
tools,
enhancement
communication
between
providers.
Language: Английский
Considerations, barriers and enablers of deprescribing among healthcare professionals in Ogun State, Southwest, Nigeria: a cross-sectional survey
Sule A. Saka,
No information about this author
Tolulope Ruth Osineye
No information about this author
BMC Health Services Research,
Journal Year:
2024,
Volume and Issue:
24(1)
Published: May 24, 2024
Abstract
Background
Deprescribing
is
a
clinical
intervention
aimed
at
managing
polypharmacy
and
improving
older
adults’
health
outcomes.
However,
evidence
suggests
that
healthcare
professionals
(HCPs)
may
face
challenges
in
implementing
the
intervention.
This
study
to
explore
considerations,
barriers
enablers
of
deprescribing
among
HCPs
Southwest
Nigeria.
Methods
A
quantitative
cross-sectional
survey
was
carried
out
consecutively
sampled
including
physicians,
pharmacists
nurses
two
public
tertiary
hospitals
Ogun
State,
Southwest,
structured
43-item
self-administered
questionnaire
used
participants’
sociodemographics,
HCPs’
experience,
adults.
The
data
were
summarised
using
descriptive
statistics
frequency
percentage.
Kruskal–Wallis
test
determine
differences
perceptions
groups
on
Likert
scale.
p
-value
<
0.05
considered
significant.
Results
Overall,
453
copies
analysed.
Of
participants
204
(45.0%)
within
age
group
20–30
years;
173
(38.2%)
claimed
adults
occasionally
requested
their
medications.
majority
(417;
92.1%)
patients’
quality
life
be
very
important
deprescribing;
423
(93.4%)
opined
having
care
goal
known
members
HCP
team
an
enabler
for
while
308
(68.0%)
disagreed
or
strongly
lack
incentives
remuneration
de-prescribe
barrier
deprescribing.
There
significant
difference
across
professional
assertion
pressure
from
pharmaceutical
companies
(
=
0.037).
Conclusions
this
had
various
considerations
medication
life.
Having
every
involved
patient
not
necessarily
need
regulations
policies
support
identified
reduce
effective
process.
Language: Английский
Pharmacist-Led Deprescribing of Opioids and Benzodiazepines in Older Adults: Examining Implementation and Perceptions
Tamera D. Hughes,
No information about this author
Elizabeth Sottung,
No information about this author
Juliet Nowak
No information about this author
et al.
Pharmacy,
Journal Year:
2024,
Volume and Issue:
12(4), P. 119 - 119
Published: July 30, 2024
Background:
This
study
examines
the
implementation
and
perceptions
of
a
pharmacist
consultant
deprescribing
program
aimed
at
reducing
risk
falls
in
older
adults
using
opioids
benzodiazepines.
Methods:
qualitative
conducted
interviews
with
healthcare
providers.
The
were
from
August
to
December
2021
analyzed
inductive
coding
techniques.
Results:
Five
participants,
predominantly
female
MDs
or
PA-Cs
rural
clinics,
interviewed.
participants
adopted
pharmacist-led
due
their
heightened
awareness
opioid
crisis,
dedication
patient
safety,
desire
for
education.
Initially,
concerns
included
resistance
provider-driven
barriers.
However,
over
time,
attitudes
shifted
toward
greater
openness
program.
providers
emphasized
several
critical
needs
success
program:
guaranteed
access
pharmacists,
tailored
education,
resources
specific
providers,
financial
support,
including
telehealth
options.
These
factors
deemed
essential
overcoming
initial
barriers
ensuring
effective
implementation.
Conclusion:
Integrating
pharmacists
into
primary
care
settings
shows
promise
benzodiazepines
adults.
Future
research
should
explore
options
patient–pharmacist
consultations
expand
application
these
findings
other
settings.
highlights
importance
awareness,
(pharmacists),
provider
support
addressing
among
Language: Английский