Abstract

BackgroundThere is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care, and to describe the barriers and enablers of the process from the point of view of patients and healthcare professionals.MethodsWe designed an umbrella review which includes nine systematic reviews. More than 50% of included studies were performed with adults in primary care. Two reviewers independently performed data extraction and analysis.ResultsIn considering studies of the effectiveness of interventions, it can be observed that the educational component of deprescription procedures is a key factor, whilst procedures tailored towards the patient’s situation offer better results. With regards to studies involving healthcare professionals, the main explored areas were the balance between risks and benefits, and the need to improve communication with patients as well as other colleagues involved in patient care. Amongst the identified barriers we found lack of time, inability to access all information, being stuck in a routine, resistance to change and a lack of willingness to question the prescription decisions made by healthcare colleagues. With regards to patients, it is clear that they have worries and doubts. In order to overcome these issues, a good relationship with healthcare professionals and receipt of their support is required during the process.ConclusionsOptimizing medication through targeted deprescribing is an important part of managing chronic conditions, avoiding adverse effects and improving outcomes. The majority of deprescription interventions in primary care are effective. Good communication between healthcare professionals is a key element for success in the deprescription process.

Highlights

  • There is a high prevalence of potentially inappropriate prescriptions in primary care

  • Effectiveness of deprescription interventions Three systematic reviews were included to accomplish the aim of assessing the effectiveness of interventions

  • The first of them analysed health outcomes amongst patients aged over 65 years old and the nature of the deprescription process for one or more drugs undertaken by a physician [17]

Read more

Summary

Introduction

There is a high prevalence of potentially inappropriate prescriptions in primary care This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. Potentially inappropriate medicines (PIM) are seen to exist amongst different procedures or health technologies. These are estimated to be used by 11.5–62.5% of the elderly population [3, 4]. Polypharmacy and the use of PIM have been associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments [5,6,7,8,9]. A great variety of factors are associated with the discontinuation of treatment such as patient characteristics, patient or care-giver choices, medication-related factors (eg, duration of action, risk–benefit profile, etc.) and practitioner-related or health system-related factors [10]

Methods
Results
Discussion
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.