A practitioner behaviour change intervention for deprescribing in the hospital setting

Scott, Sion, May, Helen, Patel, Martyn, Wright, David J. and Bhattacharya, Debi (2020) A practitioner behaviour change intervention for deprescribing in the hospital setting. Age and Ageing. ISSN 0002-0729

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Abstract

Background: Hospital deprescribing trials have demonstrated marginal increases in deprescribing activity that are not sustained beyond the trial period. The hospital deprescribing implementation framework (hDIF) links barriers and enablers of deprescribing in hospital with 44 potential intervention components. This study aimed to support geriatricians and pharmacists to select and characterise hDIF components according to affordability, practicability, effectiveness, acceptability, safety and equity (APEASE) to design a deprescribing intervention in the English hospital setting. Methods: We convened a modified Nominal Group Technique with a panel of nine geriatricians and pharmacists representing five English hospitals. Panel members selected and characterised intervention components from the hDIF based on the APEASE criteria. We set a consensus threshold of 80% agreement per APEASE criterion in order for the intervention component to be included. Results The panel selected five intervention components supporting engagement with deprescribing: an organisational action plan to prioritise deprescribing; two training activities to address pharmacists’ beliefs about negative deprescribing consequences; restructuring pharmacists’ working patterns to facilitate their contribution to deprescribing decisions; sharing experiences of successfully engaging patients/family in deprescribing conversations to support others to do the same. A sixth component was selected to sustain engagement with deprescribing through measuring and sharing deprescribing activity achieved between teams. Conclusions: Deprescribing interventions targeting geriatricians’ and pharmacists’ behaviour in the English hospital context should include the six characterised components. A component to sustain deprescribing activity is a notable omission from previously reported deprescribing interventions and may explain their failure to maintain efficacy beyond the short-term trial period.

Item Type: Article
Faculty \ School: Faculty of Science > School of Pharmacy
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 17 Jul 2020 23:45
Last Modified: 25 Sep 2020 23:53
URI: https://ueaeprints.uea.ac.uk/id/eprint/76162
DOI: 10.1093/ageing/afaa169

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