Abstract
Pharmacists play a key role in deprescribing medications. Incorporation of this concept into pharmacy school curricula is important in ensuring that graduates can address the complex needs of an aging population. The aims of this study were to assess if and how student pharmacists were exposed to deprescribing within their curriculum, to assess students’ perceptions regarding their attitudes, ability and confidence in deprescribing, and to assess if reported curricular exposure to this topic resulted in improved perceptions or objective knowledge assessment scores. An electronic survey was distributed to third- and fourth-year pharmacy students at 132 schools of pharmacy. The survey included three sections including: (i) demographics and questions on their exposure to deprescribing and other experiences within their curriculum; (ii) questions regarding their attitudes, ability, and confidence regarding deprescribing on a 5-point Likert-scale; (iii) a knowledge assessment on polypharmacy and deprescribing in the form of 12 multiple-choice questions. Likert-scale questions were analyzed as scales utilizing the mean score for items measuring student perceptions regarding deprescribing attitudes, ability, and confidence. Comparisons were made on each variable between students with and without curricular exposure to deprescribing using t-tests. Ninety-one responses were included in the analysis. Only 59.3% of respondents reported exposure to deprescribing in their didactic coursework. The mean scores on the polypharmacy and deprescribing knowledge assessments were 61.0% and 64.5%, respectively. Those with exposure to deprescribing concepts within their curriculum were more likely to agree that their school’s curriculum prepared them to deprescribe in clinical practice (t(89) = −2.26, p = 0.03). Pharmacy schools should evaluate their curricula and consider the addition of specific deprescribing objectives and outcome measures for didactic and experiential training.
Highlights
Polypharmacy, defined as the use of multiple medications, is recognized as a risk factor for adverse drug reactions and healthcare utilization among older adults [1,2,3]
Forty responses were excluded for various reasons, including the student was not a third professional year (P3) or fourth professional year (P4) student (n = 16), a scale score could not be computed due to >75% of items from a scale missing a response (n = 12), and missing responses to knowledge assessment questions (n = 12)
Pharmacists play a key role in the practice of deprescribing and must be practice-ready in order to address the complex needs of an aging population
Summary
Polypharmacy, defined as the use of multiple medications, is recognized as a risk factor for adverse drug reactions and healthcare utilization among older adults [1,2,3]. Pharmacy 2020, 8, 220 potential benefits within the context of an individual patient’s care goals, current level of functioning, life expectancy, values, and preferences,” is a term that is gaining traction throughout the medical community [7,8]. Pharmacists are uniquely positioned and trained to regularly assess a patient’s medication regimen and identify older adults at risk for adverse drug events [9]. It has been suggested that a key change to increase the practice of deprescribing is educating health care providers at the undergraduate, graduate, and continuing professional education levels, which would include instruction on deprescribing as part of the curricula in medical and pharmacy education [16,17]
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