Identifying Deprescribing Implementation Strategies and Resources

• Research type

  Research Study

• Full title

  Deprescribing in Primary Care: identifying and developing deprescribing implementation resources

• IRAS ID

  288393

• Contact name

  Daniel Okeowo

• Contact email

  umdao@leeds.ac.uk

• Sponsor organisation

  University of Leeds

• Duration of Study in the UK

  0 years, 6 months, 1 days

• Research summary

  Research Summary

  With the use of medicines increasing globally, there is a growing risk that polypharmacy (the concurrent use of 5 or more medicines) may become problematic for patients, compromising patient safety (Duerden et al., 2013). Deprescribing, ceasing medicines when risks outweigh benefits, has shown potential in addressing the problematic use of medicines (Scott et al., 2015). However, much of the current evidence surrounding deprescribing focuses on the how to deprescribe with very little work investigating how deprescribing can be implemented into our current healthcare system. This is important as poor implementation planning may lead to deprescribing interventions failing, stopping the benefits being realised (Luig et al., 2018).
  
  This study will use qualitative online focus groups with patients, GPs, pharmacists and Clinical Commissioning Group staff to discuss deprescribing implementation. These focus groups will discuss the patient support and education required, any known barriers and facilitators to deprescribing and the role of pharmacists (community and practice) in the process of deprescribing. Based on the findings of the focus groups, implementation strategies will be selected from the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy of health systems interventions.
  
  The objectives are to:

  1. Explore and identify the optimal way to safely implement deprescribing in primary care, and the role of pharmacists within this, by determining the view of stakeholders
  2. Identify patient-centred resources to support deprescribing in primary care
  3. Identify healthcare professional resources to support deprescribing in primary care

  Summary of Results

  Twenty patients were recruited, and three main themes developed from interviews: 1. ‘Why deprescribe now’ focused on the importance of communicating the deprescribing rationale; 2. ‘Monitoring and follow-up’ in which safety netting around deprescribing and patients’ motivations to self-monitor after deprescribing interventions were highlighted; 3. ‘Roles and relationships’ focused on patient views of different healthcare professionals involved in deprescribing and the interpersonal skills needed to develop therapeutic relationships.

  Healthcare professionals expressed that current healthcare is focused on prescribing with minimal deprescribing consideration, how stakeholder buy-in can drive implementation, how safety can be maintained through follow-ups and safety nets, and the potential role of community pharmacists.

• REC name

  East of Scotland Research Ethics Service REC 1

• REC reference

  21/ES/0020

• Date of REC Opinion

  23 Mar 2021

• REC opinion

  Further Information Favourable Opinion