Abstract
While clinical deprescribing trials are increasingly being performed, there is no guidance on the optimum conduction of such studies. The aim of this survey was to explore the perspectives, attitudes, interests, barriers, and enablers of conducting clinical deprescribing trials among health professionals and researchers. An anonymous survey was developed, reviewed, and piloted by all investigators and informed by consultation with experts, as well as current deprescribing guidelines. The questions were formulated around current clinical trial frameworks and incorporated identified enablers and barriers of performing deprescribing studies. The survey was sent to members of Australian and international deprescribing, pharmacological, and pharmacy organizations, and other researchers published in deprescribing. A total of 96 respondents completed the survey (92.3% completion rate). Respondents indicated the main deprescribing trial rationale is to generate evidence to optimize patient‐centered outcomes (79.2%). Common barriers identified included the time and effort required (18.2%), and apprehension of health professionals involved in trials (17.1%). Studies are enabled by positive attitudes toward deprescribing of treating prescribers (24.4%) and patients (20.9%). Classical randomized controlled trials (RCTs) were deemed the most appropriate methodology (93.2%). Sixty percent of participants indicated a good clinical practice framework is required to guide the conduct of deprescribing trials. There were no significant differences in responses based on previous experience in conducting clinical deprescribing trials. In conclusion, clinical deprescribing trials should be conducted to investigate whether deprescribing medications improves patient care. A future deprescribing trial framework should use classical RCTs as a model, ensure participant safety, and target patient‐centered outcomes.
Highlights
Despite many deprescribing studies being in progress internationally, there is an ongoing recognition of the need to conduct quality, robust clinical deprescribing trials to investigate the benefits and safety of stopping medicines.[2,3,4]
There were no significant differences between responses to all questions based on participants’ previous experience in conducting clinical deprescribing trials
The most common barriers were the time and effort required for a clinical deprescribing trial, and the apprehension toward deprescribing of a health
Summary
Deprescribing has been identified as the patient-centered process of withdrawing potentially harmful or unnecessary medications in order to improve health outcomes.[1] Despite many deprescribing studies being in progress internationally, there is an ongoing recognition of the need to conduct quality, robust clinical deprescribing trials to investigate the benefits and safety of stopping medicines.[2,3,4] study design and outcomes often vary, leading to great heterogeneity in the literature, and presenting challenges for researchers and practitioners to synthesize results and implement recommendations into clinical practice.[5,6,7,8]. Attitudes, interests, and perceived barriers and enablers in relation to conducting clinical deprescribing trials among health professionals and researchers
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