Elderly patients’ and GPs’ perspectives of patient–GP communication concerning polypharmacy: a qualitative interview study

Schöpf, Andrea C.; Hirschhausen, Maike von; Farin, Erik; Maun, Andy

doi:10.1017/s1463423617000883

Cited by 24 publications

(42 citation statements)

References 31 publications

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“…The studies were conducted across a number of countries with varied health systems. Only 2 studies included the perspectives of both GPs and medication users . Thirteen studies included only older adult participants.…”

Section: Resultsmentioning

confidence: 99%

“…Older adults often need to consult with more than one prescriber in the course of managing multiple morbidities; this may result in an increased risk of poor communication regarding medications between prescribers and confusion about responsibilities . General practitioners view this as a potential barrier to enacting deprescribing.…”

Section: Resultsmentioning

confidence: 99%

“…Older adults varied in their interest for more information about their medications and involvement in decision making . For example, raising the topic of discontinuing a medication was initiated by only 18% of older adults in a Norwegian study, while 55% had done so in a US study and 42% in a Canadian study .…”

Section: Resultsmentioning

confidence: 99%

“…The Canadian study found that initiating a deprescribing conversation was more likely in older adults who searched for information about and had an awareness of medication harms . In contrast, some older adults felt fearful about expressing their medication preferences and did not share their experience of trialling deprescribing themselves until after the fact …”

Section: Resultsmentioning

confidence: 99%

“…An incomplete clinical picture regarding their older patients was another knowledge limitation that negatively impacted GPs' capability to deprescribe. This may result from patients not communicating important information regarding their medications . Furthermore, other prescribers, such as medical specialists, may not effectively communicate all their treatment plans (eg, medication indications and/or duration of treatment) to the GP …”

Section: Resultsmentioning

confidence: 99%

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Deprescribing medications for older adults in the primary care context: A mixed studies review

Gillespie

Harrison

Mullan

2018

Health Science Reports

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Aims: This review investigates the factors that influence deprescribing of medications in primary care from the perspective of general practitioners (GPs) and community-living older adults. Methods:A mixed studies review structure was adopted searching Scopus, CINAHL, PsychINFO, ProQuest, and PubMed from January 2000 to December 2017. A manual search of reference lists was also conducted. Studies were included if they were original research available in English and explored general deprescribing rather than deprescribing of a specific class of medications. The Mixed Methods Assessment Tool was used to assess the quality of studies, and content analysis generated common categories across studies.Results: Thirty-eight articles were included, and 7 key categories were identified.The review found that the factors that influence deprescribing are similar across and within health systems and mostly act as barriers. These factors remained unchanged across the review period. The structural organisation of health systems remains poorly suited to facilitate deprescribing. Individual knowledge gaps of both GPs and older adults influence practices and attitudes towards deprescribing, and significant communication gaps occur between GPs and specialists and between GPs and older adults. As a result, deprescribing decision making is characterised by uncertainty, and deprescribing is often considered only when medication problems have already arisen. Trust plays a complex role, acting as both a barrier and facilitator of deprescribing. towards reducing polypharmacy (including deprescribing), from the perspective of both community-living older adults and GPs. This is important because, as mentioned earlier, deprescribing is most often considered in the context of the treatment of older adults. ConclusionsThe purpose of the current review is to build on Bokhof and JuniusWalker 24 work by investigating the factors that influence deprescribing from the perspective of both GPs and adults aged 65 years or older.Independent, community-living older adults are the focus of this review, as the majority of this group retain autonomy and are capable of being responsible for their own health decisions, 17 hence the importance of considering deprescribing from their perspective. Given the increasing evidence that is now available on this topic, a review that incorporates all study types is warranted. Interventions to promote deprescribing will require change on the part of both prescribers and older adults, so it is important to consider how their views interact to create the context where deprescribing discussions can take place. | METHODSA mixed studies review methodology was used as a guide to explore the factors that influence deprescribing. 27,282.1 | Eligibility criteria | Inclusion criteriaFull text primary research articles were included that were available in English, published between January 2000 and December 2017, and that investigated deprescribing or medication cessation/discontinuation in the primary care context for ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%