Health care professionals’ attitudes towards deprescribing in older patients with limited life expectancy

a systematic review

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Resumé

Aims: The aim of this systematic review was to explore health care professionals' attitudes towards deprescribing in older people with limited life expectancy. Methods: A systematic literature search was conducted from inception to December 2017 using MEDLINE, EMBASE and CINAHL. Studies were included if they specifically concerned older people (≥65 years) with limited life expectancy, including those residing in any type of aged care facility, or were based on representative patient profiles. Results were analyzed inspired by the Joanna Briggs Institute's method for synthesis of qualitative data. Studies were characterized using a checklist for reporting of qualitative research. Results: Eight studies were included. Six studies explored health care professionals' views on deprescribing in general, and two studies focused specifically on psychotropic agents. All eight studies explored the views of physicians, mostly general practitioners, while three studies also considered other health care professionals. Four themes related to health care professionals' attitudes towards deprescribing were identified: (i) patient and relative involvement; (ii) the importance of teamwork; (iii) health care professionals' self-assurance and skills; and (iv) the impact of organizational factors. Within each of these themes, 3–4 subthemes were identified and analysed. Conclusions: Our results suggest that health care professionals' decisions to engage in deprescribing activities with older people with limited life expectancy depend on multiple factors which are highly interdependent. Consequently, there is an urgent need for more research on how to approach deprescribing in clinical practice within this population.

OriginalsprogEngelsk
TidsskriftBritish Journal of Clinical Pharmacology
Vol/bind85
Udgave nummer5
Sider (fra-til)868-892
ISSN0306-5251
DOI
StatusUdgivet - maj 2019

Fingeraftryk

Life Expectancy
Delivery of Health Care
Patient Advocacy
Qualitative Research
Checklist
MEDLINE
General Practitioners
Deprescriptions
Physicians
Research
Population

Citer dette

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title = "Health care professionals’ attitudes towards deprescribing in older patients with limited life expectancy: a systematic review",
abstract = "Aims: The aim of this systematic review was to explore health care professionals' attitudes towards deprescribing in older people with limited life expectancy. Methods: A systematic literature search was conducted from inception to December 2017 using MEDLINE, EMBASE and CINAHL. Studies were included if they specifically concerned older people (≥65 years) with limited life expectancy, including those residing in any type of aged care facility, or were based on representative patient profiles. Results were analyzed inspired by the Joanna Briggs Institute's method for synthesis of qualitative data. Studies were characterized using a checklist for reporting of qualitative research. Results: Eight studies were included. Six studies explored health care professionals' views on deprescribing in general, and two studies focused specifically on psychotropic agents. All eight studies explored the views of physicians, mostly general practitioners, while three studies also considered other health care professionals. Four themes related to health care professionals' attitudes towards deprescribing were identified: (i) patient and relative involvement; (ii) the importance of teamwork; (iii) health care professionals' self-assurance and skills; and (iv) the impact of organizational factors. Within each of these themes, 3–4 subthemes were identified and analysed. Conclusions: Our results suggest that health care professionals' decisions to engage in deprescribing activities with older people with limited life expectancy depend on multiple factors which are highly interdependent. Consequently, there is an urgent need for more research on how to approach deprescribing in clinical practice within this population.",
keywords = "drug safety, elderly, prescribing",
author = "Carina Lundby and Trine Graab{\ae}k and Jesper Ryg and Jens S{\o}ndergaard and A Potteg{\aa}rd and Nielsen, {Dorthe Susanne}",
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T1 - Health care professionals’ attitudes towards deprescribing in older patients with limited life expectancy

T2 - a systematic review

AU - Lundby, Carina

AU - Graabæk, Trine

AU - Ryg, Jesper

AU - Søndergaard, Jens

AU - Pottegård, A

AU - Nielsen, Dorthe Susanne

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N2 - Aims: The aim of this systematic review was to explore health care professionals' attitudes towards deprescribing in older people with limited life expectancy. Methods: A systematic literature search was conducted from inception to December 2017 using MEDLINE, EMBASE and CINAHL. Studies were included if they specifically concerned older people (≥65 years) with limited life expectancy, including those residing in any type of aged care facility, or were based on representative patient profiles. Results were analyzed inspired by the Joanna Briggs Institute's method for synthesis of qualitative data. Studies were characterized using a checklist for reporting of qualitative research. Results: Eight studies were included. Six studies explored health care professionals' views on deprescribing in general, and two studies focused specifically on psychotropic agents. All eight studies explored the views of physicians, mostly general practitioners, while three studies also considered other health care professionals. Four themes related to health care professionals' attitudes towards deprescribing were identified: (i) patient and relative involvement; (ii) the importance of teamwork; (iii) health care professionals' self-assurance and skills; and (iv) the impact of organizational factors. Within each of these themes, 3–4 subthemes were identified and analysed. Conclusions: Our results suggest that health care professionals' decisions to engage in deprescribing activities with older people with limited life expectancy depend on multiple factors which are highly interdependent. Consequently, there is an urgent need for more research on how to approach deprescribing in clinical practice within this population.

AB - Aims: The aim of this systematic review was to explore health care professionals' attitudes towards deprescribing in older people with limited life expectancy. Methods: A systematic literature search was conducted from inception to December 2017 using MEDLINE, EMBASE and CINAHL. Studies were included if they specifically concerned older people (≥65 years) with limited life expectancy, including those residing in any type of aged care facility, or were based on representative patient profiles. Results were analyzed inspired by the Joanna Briggs Institute's method for synthesis of qualitative data. Studies were characterized using a checklist for reporting of qualitative research. Results: Eight studies were included. Six studies explored health care professionals' views on deprescribing in general, and two studies focused specifically on psychotropic agents. All eight studies explored the views of physicians, mostly general practitioners, while three studies also considered other health care professionals. Four themes related to health care professionals' attitudes towards deprescribing were identified: (i) patient and relative involvement; (ii) the importance of teamwork; (iii) health care professionals' self-assurance and skills; and (iv) the impact of organizational factors. Within each of these themes, 3–4 subthemes were identified and analysed. Conclusions: Our results suggest that health care professionals' decisions to engage in deprescribing activities with older people with limited life expectancy depend on multiple factors which are highly interdependent. Consequently, there is an urgent need for more research on how to approach deprescribing in clinical practice within this population.

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