L Djatche1, S Lee1, D Singer1, S E Hegarty2, M Lombardi3, V Maio1. 1. College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA. 2. Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA. 3. Parma Local Health Authority, Parma, Italy.
Abstract
WHAT IS KNOWN AND OBJECTIVE: Deprescribing is the process of discontinuing or reducing the dosage of medications that are no longer appropriate or aligned with goals of care, which is paramount in elderly patients with multiple comorbidities and polypharmacy. The objective of this study was to assess the perceptions of primary care physicians on deprescribing for elderly patients and potential barriers to deprescribing that physicians experience in the Local Health Authority (LHA) of Parma, Emilia-Romagna, Italy. METHODS: One hundred and sixty physicians (57% of the total number of primary care physicians in Parma) attended an educational session related to deprescribing and were asked to anonymously complete a paper survey. Participants were asked to assess their level of agreement on nine questions about their perception of deprescribing and potential factors affecting the deprescribing process using a seven-point Likert-type scale. A correlation coefficient was calculated to assess the association between physicians' confidence in deprescribing and attitudes or barriers associated with deprescribing. RESULTS AND DISCUSSION: Many physicians (72%) reported general confidence in their ability to deprescribe. Most respondents (78%) reported they were comfortable deprescribing preventive medications, yet only half (53%) were comfortable deprescribing guideline-recommended therapies. Lack of evidence on discontinuing preventive medicines and concern about withdrawal side effects were reported to impede deprescribing by more than one-third of physicians. When medications were initially prescribed by another physician, 40% of physicians reported hesitance in deprescribing them. About half of physicians (45%) did not feel comfortable deprescribing when patients/caregivers believed that continuation of the medication was needed. Lack of time and difficulty engaging patients/caregivers in the deprescribing process were cited as barriers by about one in four physicians. There was no strong correlation between physicians' confidence and attitudes or barriers associated with deprescribing. WHAT IS NEW AND CONCLUSION: The study results show that physicians believe they are generally comfortable with deprescribing, although there are still several factors that hamper their ability to engage in the process. An improved understanding of physicians' views on deprescribing may help guide further research, and policies to help patients remain healthy while streamlining their medication regimen.
WHAT IS KNOWN AND OBJECTIVE: Deprescribing is the process of discontinuing or reducing the dosage of medications that are no longer appropriate or aligned with goals of care, which is paramount in elderly patients with multiple comorbidities and polypharmacy. The objective of this study was to assess the perceptions of primary care physicians on deprescribing for elderly patients and potential barriers to deprescribing that physicians experience in the Local Health Authority (LHA) of Parma, Emilia-Romagna, Italy. METHODS: One hundred and sixty physicians (57% of the total number of primary care physicians in Parma) attended an educational session related to deprescribing and were asked to anonymously complete a paper survey. Participants were asked to assess their level of agreement on nine questions about their perception of deprescribing and potential factors affecting the deprescribing process using a seven-point Likert-type scale. A correlation coefficient was calculated to assess the association between physicians' confidence in deprescribing and attitudes or barriers associated with deprescribing. RESULTS AND DISCUSSION: Many physicians (72%) reported general confidence in their ability to deprescribe. Most respondents (78%) reported they were comfortable deprescribing preventive medications, yet only half (53%) were comfortable deprescribing guideline-recommended therapies. Lack of evidence on discontinuing preventive medicines and concern about withdrawal side effects were reported to impede deprescribing by more than one-third of physicians. When medications were initially prescribed by another physician, 40% of physicians reported hesitance in deprescribing them. About half of physicians (45%) did not feel comfortable deprescribing when patients/caregivers believed that continuation of the medication was needed. Lack of time and difficulty engaging patients/caregivers in the deprescribing process were cited as barriers by about one in four physicians. There was no strong correlation between physicians' confidence and attitudes or barriers associated with deprescribing. WHAT IS NEW AND CONCLUSION: The study results show that physicians believe they are generally comfortable with deprescribing, although there are still several factors that hamper their ability to engage in the process. An improved understanding of physicians' views on deprescribing may help guide further research, and policies to help patients remain healthy while streamlining their medication regimen.
Authors: Christopher J D Threapleton; James E Kimpton; Iain M Carey; Stephen DeWilde; Derek G Cook; Tess Harris; Emma H Baker Journal: Br J Clin Pharmacol Date: 2020-03-16 Impact factor: 4.335
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
Authors: Aimee N Pickering; Megan E Hamm; Alicia Dawdani; Joseph T Hanlon; Carolyn T Thorpe; Walid F Gellad; Thomas R Radomski Journal: J Am Geriatr Soc Date: 2020-02-17 Impact factor: 5.562
Authors: Karolina Kuberska; Fiona Scheibl; Carol Sinnott; James P Sheppard; Mark Lown; Marney Williams; Rupert A Payne; Jonathan Mant; Richard J McManus; Jenni Burt Journal: Br J Gen Pract Date: 2021-06-24 Impact factor: 6.302
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