Impact of interdisciplinary approaches to deprescribing psychotropics on clinical outcomes in older residents of long-term care facilities

Harrison, Stephanie L; Sluggett, Janet K.

doi:10.1017/s1041610220001453

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Pharmacists are identified as deprescribing facilitators, offering knowledge, support and confidence in decision making. Similar campaigns exist internationally promoting the integration of pharmacists into long-term care, to provide clinical services, participate in discussions and educate staff [ 62 ]. A systematic review by Sadowski et al concluded that there is evidence to support the integration of a pharmacist into long-term care, particularly to provide medication reviews to increase medication appropriateness, supporting the response from study participants [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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

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Section: Discussionmentioning

confidence: 99%