Literature DB >> 29088989

Negotiating "Unmeasurable Harm and Benefit": Perspectives of General Practitioners and Consultant Pharmacists on Deprescribing in the Primary Care Setting.

Kristen Anderson1, Michele Foster2,3, Christopher Freeman1, Karen Luetsch1, Ian Scott1,4.   

Abstract

The use of multiple medicines, known as polypharmacy, poses a risk of harm that is greatest in older adults with multimorbidity. Deprescribing aims to improve health outcomes through ceasing medicines that are no longer necessary or appropriate due to changing clinical circumstances and patient priorities. General practitioners (GPs) and consultant pharmacists (CPs) are well positioned to facilitate deprescribing in primary care in partnership with older adults who present with inappropriate polypharmacy. In this article, we explore GPs' and CPs' views about inappropriate polypharmacy, the reasoning they apply to deprescribing in primary care, and identify factors that support or inhibit this process. Using focus group methodology and the Framework Method for thematic analysis, two major themes were discerned from the data-working through uncertainty and risk perception as a frame of reference. The findings provide important insights when devising methods for advancing and supporting deprescribing in primary care.

Entities:  

Keywords:  Australia; aging; chronic disease; chronic illness; older adults; primary health care; qualitative research; risk

Mesh:

Year:  2017        PMID: 29088989     DOI: 10.1177/1049732316687732

Source DB:  PubMed          Journal:  Qual Health Res        ISSN: 1049-7323


  21 in total

1.  Deprescribing admission medication at a UK teaching hospital; a report on quantity and nature of activity.

Authors:  Sion Scott; Allan Clark; Carol Farrow; Helen May; Martyn Patel; Michael James Twigg; David John Wright; Debi Bhattacharya
Journal:  Int J Clin Pharm       Date:  2018-06-20

2.  Health care professionals' attitudes towards deprescribing in older patients with limited life expectancy: A systematic review.

Authors:  Carina Lundby; Trine Graabaek; Jesper Ryg; Jens Søndergaard; Anton Pottegård; Dorthe Susanne Nielsen
Journal:  Br J Clin Pharmacol       Date:  2019-02-27       Impact factor: 4.335

3.  Assessment of Attitudes Toward Deprescribing in Older Medicare Beneficiaries in the United States.

Authors:  Emily Reeve; Jennifer L Wolff; Maureen Skehan; Elizabeth A Bayliss; Sarah N Hilmer; Cynthia M Boyd
Journal:  JAMA Intern Med       Date:  2018-12-01       Impact factor: 21.873

Review 4.  Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis.

Authors:  Joanne Reeve; Michelle Maden; Ruaraidh Hill; Amadea Turk; Kamal Mahtani; Geoff Wong; Dan Lasserson; Janet Krska; Dee Mangin; Richard Byng; Emma Wallace; Ed Ranson
Journal:  Health Technol Assess       Date:  2022-07       Impact factor: 4.106

5.  Total uncertainty: a systematic review and thematic synthesis of experiences of uncertainty in older people with advanced multimorbidity, their informal carers and health professionals.

Authors:  Simon Noah Etkind; Jiaqi Li; John Louca; Sarah A Hopkins; Isla Kuhn; Anna Spathis; Stephen I G Barclay
Journal:  Age Ageing       Date:  2022-08-02       Impact factor: 12.782

6.  The evolution of an evidence based intervention designed to improve prescribing and reduce polypharmacy in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE).

Authors:  Caroline McCarthy; Frank Moriarty; Emma Wallace; Susan M Smith
Journal:  J Comorb       Date:  2020-09-14

7.  Patient and Physician Perspectives of Deprescribing Potentially Inappropriate Medications in Older Adults with a History of Falls: a Qualitative Study.

Authors:  Erin E Hahn; Corrine E Munoz-Plaza; Eric Anthony Lee; Tiffany Q Luong; Brian S Mittman; Michael H Kanter; Hardeep Singh; Kim N Danforth
Journal:  J Gen Intern Med       Date:  2021-01-19       Impact factor: 6.473

8.  General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.

Authors:  Raechel A Damarell; Deidre D Morgan; Jennifer J Tieman
Journal:  BMC Fam Pract       Date:  2020-07-01       Impact factor: 2.497

Review 9.  Pharmacist interventions to deprescribe opioids and benzodiazepines in older adults: A rapid review.

Authors:  Joshua D Niznik; Brendan J Collins; Lori T Armistead; Claire K Larson; Casey J Kelley; Tamera D Hughes; Kimberly A Sanders; Rebecca Carlson; Stefanie P Ferreri
Journal:  Res Social Adm Pharm       Date:  2021-07-16

10.  Exploring how GPs discuss statin deprescribing with older people: a qualitative study.

Authors:  Wade Thompson; Jette Videbæk Le; Peter Haastrup; Jesper Bo Nielsen; Line Bjørnskov Pedersen; Dorte Ejg Jarbøl
Journal:  BJGP Open       Date:  2020-05-01
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