The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians

Background and objective: There are barriers to deprescription that hinder its implementation in clinical practice. The objective of this study was to analyse the main barriers and limitations of the deprescription process perceived by physicians who care for multipathological patients. Materials an...

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Main Authors: Marta Mejías-Trueba, Aitana Rodríguez-Pérez, Emilio García-Cabrera, Carlos Jiménez-Juan, Susana Sánchez-Fidalgo
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Healthcare
Subjects:
Online Access:https://www.mdpi.com/2227-9032/11/13/1879
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author Marta Mejías-Trueba
Aitana Rodríguez-Pérez
Emilio García-Cabrera
Carlos Jiménez-Juan
Susana Sánchez-Fidalgo
author_facet Marta Mejías-Trueba
Aitana Rodríguez-Pérez
Emilio García-Cabrera
Carlos Jiménez-Juan
Susana Sánchez-Fidalgo
author_sort Marta Mejías-Trueba
collection DOAJ
description Background and objective: There are barriers to deprescription that hinder its implementation in clinical practice. The objective of this study was to analyse the main barriers and limitations of the deprescription process perceived by physicians who care for multipathological patients. Materials and methods: The “<i>deprescription questionnaire of elderly patients</i>” was adapted to an online format and sent to physicians in geriatrics. Question 1 is a reference to establish agreement or disagreement with this practice. The influence of different aspects of deprescription was analysed via the demographic characteristics of the clinicians and perceptions of the various barriers (questions 2–9) by means of bivariate analysis. Based on the latter, a multivariate model was carried out to demonstrate the relationship between barriers and the degree of deprescription agreement among respondents. Results: Of the 72 respondents, 72.2% were in favour of deprescribing. Regarding the analyses, the demographic characteristics did not influence rankings. The deprescription of preventive drugs and consensus with patients were associated with a positive attitude towards deprescribing, while withdrawing drugs prescribed by other professionals, time constraints and patient reluctance emerged as possible barriers. The only factor independently associated with deprescribing was lack of time. Conclusions: Time was found to be the main barrier to deprescription. Training, the creation of multidisciplinary teams and integrated health systems are key facilitators.
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spelling doaj.art-3e07cbee05984810a76df93a1400f5602023-11-18T16:36:25ZengMDPI AGHealthcare2227-90322023-06-011113187910.3390/healthcare11131879The Barriers to Deprescription in Older Patients: A Survey of Spanish CliniciansMarta Mejías-Trueba0Aitana Rodríguez-Pérez1Emilio García-Cabrera2Carlos Jiménez-Juan3Susana Sánchez-Fidalgo4Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Sevilla, SpainUnidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Sevilla, SpainDepartamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, 41009 Sevilla, SpainUnidad de Gestión Clínica Medicina Interna, Hospital Universitario Virgen del Rocío, 41013 Sevilla, SpainDepartamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, 41009 Sevilla, SpainBackground and objective: There are barriers to deprescription that hinder its implementation in clinical practice. The objective of this study was to analyse the main barriers and limitations of the deprescription process perceived by physicians who care for multipathological patients. Materials and methods: The “<i>deprescription questionnaire of elderly patients</i>” was adapted to an online format and sent to physicians in geriatrics. Question 1 is a reference to establish agreement or disagreement with this practice. The influence of different aspects of deprescription was analysed via the demographic characteristics of the clinicians and perceptions of the various barriers (questions 2–9) by means of bivariate analysis. Based on the latter, a multivariate model was carried out to demonstrate the relationship between barriers and the degree of deprescription agreement among respondents. Results: Of the 72 respondents, 72.2% were in favour of deprescribing. Regarding the analyses, the demographic characteristics did not influence rankings. The deprescription of preventive drugs and consensus with patients were associated with a positive attitude towards deprescribing, while withdrawing drugs prescribed by other professionals, time constraints and patient reluctance emerged as possible barriers. The only factor independently associated with deprescribing was lack of time. Conclusions: Time was found to be the main barrier to deprescription. Training, the creation of multidisciplinary teams and integrated health systems are key facilitators.https://www.mdpi.com/2227-9032/11/13/1879deprescriptionquestionnairecliniciansbarriers
spellingShingle Marta Mejías-Trueba
Aitana Rodríguez-Pérez
Emilio García-Cabrera
Carlos Jiménez-Juan
Susana Sánchez-Fidalgo
The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
Healthcare
deprescription
questionnaire
clinicians
barriers
title The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
title_full The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
title_fullStr The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
title_full_unstemmed The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
title_short The Barriers to Deprescription in Older Patients: A Survey of Spanish Clinicians
title_sort barriers to deprescription in older patients a survey of spanish clinicians
topic deprescription
questionnaire
clinicians
barriers
url https://www.mdpi.com/2227-9032/11/13/1879
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