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Beliefs and attitudes of residents, family members and healthcare professionals regarding deprescribing in long-term care: a qualitative study

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Abstract

Background

Polypharmacy is prevalent among long-term care (LTC) residents and can cause significant morbidity. In 2018, we concluded a deprescribing pilot study that reduced potentially inappropriate medication use among LTC residents.

Aim

We sought to understand the experience and views of physicians, nurses, pharmacists, LTC residents and family members who participated in the pilot study.

Method

Qualitative semi-structured interviews were conducted with residents and families, a physician, pharmacist and pharmacy student, and licensed-practical nurses. Interviews were audio recorded, transcribed, and analyzed using an inductive thematic analysis approach.

Results

Interviews with 13 participants yielded themes in 3 categories: (1) views about medication use in LTC and willingness to engage in deprescribing, (2) perceived barriers and enablers for deprescribing, and (3) impact of participating in deprescribing study. Participants were willing to engage in deprescribing; residents were motivated by physician suggestions, and family members prioritized quality of life in decision-making and wanted to be part of the decision-making process. Solutions to overcome barriers included assigning responsibility to identify deprescribing opportunities to pharmacists, scheduling rounds to enable face-to-face team discussions, and consulting families to provide missing medical history to inform deprescribing decisions. Participating in a deprescribing intervention resulted in improved healthcare professional (HCP) confidence and interprofessional collaboration, and caused continued practice change after the study.

Conclusion

Residents, families, and HCPs are concerned about problems associated with polypharmacy in LTC and are willing to consider deprescribing. Barriers to deprescribing in LTC exist but are not insurmountable. Results provide valuable insight into strategies to optimize deprescribing interventions within LTC.

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Acknowledgements

We would like to thank the staff, residents, and families of residents at St. Patrick’s Mercy Home, Lawton’s Nursing Home services, and the pharmacy students from Memorial University School of Pharmacy for their support and participating in this study.

Funding

This project was funded by a Memorial University, School of Pharmacy Undergraduate Summer Student Research Project award.

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Authors and Affiliations

  1. Faculty of Medicine, Newfoundland and Labrador, School of Pharmacy, Memorial University of Newfoundland, Memorial University of Newfoundland, St. John’s, Canada

    Steven Rowe

  2. School of Pharmacy, Memorial University of Newfoundland, 1 - 75 Tiffany Court, St. John’s, A1A 0L1, St. John’s, Newfoundland and Labrador, Canada

    Nicole Pittman, Catherine Balsom, Rebecca Druken & Deborah V Kelly

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  1. Steven Rowe
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Correspondence to Deborah V Kelly.

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Rowe, S., Pittman, N., Balsom, C. et al. Beliefs and attitudes of residents, family members and healthcare professionals regarding deprescribing in long-term care: a qualitative study. Int J Clin Pharm 44, 1370–1379 (2022). https://doi.org/10.1007/s11096-022-01419-2

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