Highlights
- •Even when aware of the relevance of deprescribing for their clinical activity, Italian physicians find deprescribing difficult. .
- •Professionals are willing to challenge themselves and the barriers to deprescribing.
- •Reviewing prescriptions regularly and enhancing collaboration with colleagues and patients are suitable strategies.
Abstract
Background
Even though increasing attention is given to deprescribing owing to the risks related
to polypharmacy in older adults, deprescribing is not yet part of clinical culture.
Methods
We conducted three focus groups with 25 internists, geriatricians and general practitioners
to explore the factors influencing the implementation of deprescribing in the Italian
context, and more specifically: i. to investigate the barriers to deprescribing; ii.
to define strategies and actions to address these barriers; and iii. to identify skills
and tools that may assist in implementing deprescribing in clinical practice. Thematic
analysis was used.
Results
Six themes were identified: Good reasons for deprescribing, Difficulties and doubts
about deprescribing, System factors affecting polypharmacy and deprescribing, Perspectives
on how to practically approach polypharmacy, Need for effective communication with
patients and caregivers, Taking responsibility and starting action.
Participants reported a willingness to challenge themselves by addressing the barriers
to deprescribing through regular review of prescriptions and collaboration with colleagues
and patients.
Conclusions
Italian internists, geriatricians and general practitioners reported many system-level
barriers to deprescribing as well as some doubts about its necessity. Strategies to
address the barriers to deprescribing include regular medication review and enhancing
collaboration with colleagues and patients. Additionally, participants were willing
to challenge themselves and use uncertainty as an impetus for deprescribing.
Keywords
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Article info
Publication history
Published online: January 24, 2020
Accepted:
January 18,
2020
Received in revised form:
January 7,
2020
Received:
August 28,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
