Healthcare providers’ knowledge and awareness of deprescribing
- At: PPR 2022 (2022)
- Type: Poster
- By: BUžANčIć, Iva (University Of Zagreb, Faculty Of Pharmacy And Biochemistry)
- Co-author(s): Iva Bužančić, Phd Student, University Of Zagreb, Faculty Of Pharmacy And Biochemistry, Croatia
Maja Ortner Hadžiabdić, Assisstant professor, Head of Centre for Applied Pharmacy, City pharmacies Zagreb, Croatia
Background information: Deprescribing, discontinuation of a medication without an indication or benefit, is a patient centred intervention aimed to improve outcomes. It requires shared-decision making as well as an interdisciplinary approach. Healthcare providers, pharmacists, or physicians, are in ideal position to suggest, discuss and lead deprescribing. For successful implementation of deprescribing it is important to assess stakeholders’ preparedness to provide such a service. This is especially important in healthcare systems with developing pharmaceutical care.
Purpose: To explore healthcare providers’ knowledge and awareness of deprescribing.
Method: A cross-sectional internet survey on primary care pharmacists and physicians in Croatia. A 20 item questionnaire scored on a 5-point Likert scale was used. The questionnaire was developed based on literature review, expert opinion and focus groups, and subsequently validated. It was designed using the LIMESurvey® software, and distributed via email through healthcare providers’ associations. An email remainder was sent two weeks after the initial invitation to complete the survey. Data were collected between November 2021 and January 2022. The questionnaire consisted of five sociodemographic, and 15 deprescribing-related items. The deprescribing-related questions explore participants’ knowledge (three items), awareness (four items), opinion (four items), confidence, and willingness to deprescribe (two items each). Factor scores range from one to five, with higher score meaning greater knowledge, awareness, confidence, or willingness to suggest deprescribing.
Results: Over 200 healthcare providers completed the survey (n= 206; 111 pharmacists and 95 physicians). Participants were mostly female (79.61%), had a median of 38 years (IQR 30-53), and a median of 12 (IQR 5-28) years of experience. More than half of participants worked in an urban area (58.25%) and in practices within or near other healthcare facilities (56.79%). The majority of participants (91.75%) agreed that deprescribing is as important as prescribing medication, and that it should involve shared-decision making (87.38%). Both pharmacist and physicians largely agreed that they are willing to suggest deprescribing to patients if appropriate (89.81% off al participant; 83.78% pharmacist and 96.84% physicians), but only 17.00% agreed that it is a simple and easy task (9.90% of pharmacists and 25.26% physicians). Pharmacist had statistically significantly higher awareness and knowledge scores than physicians (4.64±0.48 vs. 4.24±0.72; t (204)=-4.792, p<0.001 and 4.08±0.84 vs. 3.74±0.82; t (204)=-2.889, p=0.004 respectively), but lower confidence and willingness scores (2.61±0.94 vs. 3.42±0.79; t (204)=6.633, p<0.001 and 3.64±0.75 vs. 4.11±0.59; t (204)=4.905, p<0.001 respectively). Physicians, on the other hand, were more likely to suggest deprescribing if patients expressed their desire than pharmacists (51.58% vs. 34.23%; χ2 (2) =6.77, p= 0.034).
Conclusion: Healthcare providers have the willingness to suggest deprescribing, but might lack confidence to propose intervention. Future research should explore potential barriers and facilitators to gain a comprehensive view of important factors contributing to successful deprescribing implementation.