Deprescribing practice in a resource-limited setting: Healthcare
providers’ insights
Abstract
Aims: Inappropriate polypharmacy poses adverse drug events, mortality,
and high healthcare costs. Deprescribing could minimise inappropriate
polypharmacy and the consequence thereof. This study aims to evaluate
healthcare providers’ (HCPs) attitudes toward, and experiences with the
deprescribing practice. Methods: An institution-based cross-sectional
study was conducted among HCPs at the University of Gondar Referral
Hospital, Ethiopia. Perception of HCPs on deprescribing was measured by
Linsky et al. validated tool. This tool has five dimensions that could
affect HCPs’ decision to discontinue medications intentionally. One-way
ANOVA was used to test the association between socio-demographic
variables and their perception of deprescribing decisions. Results: Of
85 HCPs approached, about 82 HCPs with a 96.5% response rate were
included in the final analysis of this study. Most HCPs (87%) were less
likely or not at all to be affected by a strong relationship between
HCPs and their patients to make a deprescribing decision. However, HCPs
believed that formal education, significant physical health conditions,
objective response to the clinical endpoint of the medication (e.g.,
blood pressure), and on-the-job experience profoundly influenced them to
decide on deprescribing. According to the post-hoc analysis of one-way
ANOVA, clinical pharmacists seemed to have a better attitude toward
deprescribing decisions compared to physicians. (p = 0.025). Conclusion:
HCPs’ decision to discontinue a medication could be multifactorial, and
HCPs could be influenced by education level and their experience to
discontinue a medication intentionally. A therapy-specific deprescribing
algorithm, multidisciplinary collaboration, and continuous education
development should be instituted to guide HCPs in the deprescribing
decision process.