Differences in Factors Influencing Deprescribing between Primary Care Providers: Cross-Sectional Study

Bužančić, Iva; Hadžiabdić, Maja Ortner

doi:10.3390/ijerph20064957

Cited by 2 publications

(1 citation statement)

References 38 publications

(43 reference statements)

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“…High treatment burden, medication‐related problems and polypharmacy can lead to reduced adherence, 3,4 or they can be cause for deprescribing—a process of dose reduction or discontinuing selected medicines 5 . Of note, reduced adherence to medication is an important opportunity and reason for deprescribing identified by European geriatricians 6 …”

Section: Introductionmentioning

confidence: 99%

Older adults' adherence to medications and willingness to deprescribe: A substudy of a randomized clinical trial

Weir,

Jungo,

Streit

2023

Brit J Clinical Pharma

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Our study investigated the association between patients’ willingness to have medications deprescribed and medication adherence. This longitudinal sub‐study of the ‘Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre’ (OPTICA) trial, a cluster randomized controlled trial, took place in Swiss primary care settings. Participants were aged ≥65 years and over, with ≥3 chronic conditions, and ≥5 regular medications. At baseline the ‘revised Patient Attitudes Towards Deprescribing’ (rPATD) questionnaire was measured. The A14‐scale measured adherence (self‐report) at the 12‐month follow‐up. Multilevel linear regression analyses adjusted for baseline variables were performed. Of the 298 participants, 45% were women and the median age was 78. Participants reported a high level of adherence and willingness to have medications deprescribed. We did not find evidence for an association between patients' willingness to deprescribe and medication adherence. Further research is needed to explore the relationship between these concepts and to inform collaborative decisions about medicines in the context of polypharmacy.

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Section: Introductionmentioning

confidence: 99%

Older adults' adherence to medications and willingness to deprescribe: A substudy of a randomized clinical trial

Weir,

Jungo,

Streit

2023

Brit J Clinical Pharma

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

Lüthold,

Cateau,

Jenkinson

et al. 2024

BMC Health Serv Res

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

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Differences in Factors Influencing Deprescribing between Primary Care Providers: Cross-Sectional Study

Cited by 2 publications

References 38 publications

Older adults' adherence to medications and willingness to deprescribe: A substudy of a randomized clinical trial

Older adults' adherence to medications and willingness to deprescribe: A substudy of a randomized clinical trial

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

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