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 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.
Keywords: Deprescribing, polypharmacy, medication
discontinuation, prescriber, Ethiopia.
What’s known
- Deprescribing is a clinical practice to optimise medication use
through reducing inappropriate medication and medication burden,
thereby improving clinical outcome.
- Taking decisions to deprescribe is a complex process for healthcare
providers (HCPs). However, factors influencing the deprescribing
decision for HCPs are not well understood in a resource-limited
setting.
What’s new
- HCPs’ decision to deprescribe were influenced by their education level
and experience.
- Clinical pharmacists seemed to have a better attitude toward
deprescribing decisions compared to physicians.