Deprescribing practice in a resource-limited setting: Healthcare providers' insights

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Tegegn, Henok Getachew
Gebresillassie, Begashaw Melaku
Erku, Daniel Asfaw
Elias, Asrat
Yabeyu, Abdella Birhan
Ayele, Asnakew Achaw
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2021
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Abstract

Aims: Inappropriate polypharmacy poses risks of adverse drug events, high healthcare costs and mortality. Deprescribing could minimise inappropriate polypharmacy and the consequences thereof. The aim of this study was to evaluate healthcare providers’ (HCPs’) attitudes toward and experiences with deprescribing practice in Ethiopia. Methods: We conducted an institution-based cross-sectional survey among HCPs at the University of Gondar Comprehensive Specialized Hospital, Ethiopia. We used a validated questionnaire developed by Linsky et al. The tool included questions that explore medication characteristics, current patient clinical factors, predictions of future health states, patients’ resources to manage their own health and education and experience. One-way ANOVA was used to test the association between sociodemographic variables and their perception of deprescribing decisions. Results: Of 85 HCPs approached, about 82 HCPs completed the survey, giving a response rate of 96.5%. Most of the participants (n = 73, 89%) have scored less than 1.5 points showing they are reluctant to proactively deprescribe. Physicians seem to be affected by the significant physical health conditions (mean = 1.68) and clinical endpoint like blood pressure (mean = 1.5) to make deprescribing decisions. According to the post hoc analysis of one-way ANOVA, clinical pharmacists seemed to have a better attitude toward deprescribing decisions compared with physicians (P =.025). Conclusion: HCPs’ decision to discontinue a medication could be multifactorial. Physicians could be influenced by physical health condition and clinical endpoints for deprescribing decision. Future studies should emphasise on barriers and facilitators to deprescribing practice specific to the context in Ethiopia.

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International Journal of Clinical Practice

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© 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Deprescribing practice in a resource-limited setting: Healthcare providers' insights, International Journal of Clinical Practice, 2021, which has been published in final form at https://doi.org/10.1111/ijcp.14356. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)

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Clinical sciences

Health services and systems

Public health

Psychology

Science & Technology

Life Sciences & Biomedicine

Medicine, General & Internal

Pharmacology & Pharmacy

General & Internal Medicine

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Tegegn, HG; Gebresillassie, BM; Erku, DA; Elias, A; Yabeyu, AB; Ayele, AA, Deprescribing practice in a resource-limited setting: Healthcare providers' insights, International Journal of Clinical Practice, 2021

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