Deprescribing as an Opportunity to Facilitate Patient-Centered Care: A Qualitative Study of General Practitioners and Pharmacists in Japan

Kenya Ie (), Reiko Machino, Steven M. Albert, Shiori Tomita, Mio Kushibuchi, Masanori Hirose, Takahide Matsuda, Chiaki Okuse and Yoshiyuki Ohira
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Kenya Ie: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Reiko Machino: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Steven M. Albert: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15621, USA
Shiori Tomita: Tama Family Clinic, Kawasaki 214-0013, Japan
Mio Kushibuchi: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Masanori Hirose: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Takahide Matsuda: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Chiaki Okuse: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
Yoshiyuki Ohira: Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan

IJERPH, 2023, vol. 20, issue 4, 1-12

Abstract: Deprescribing has recently been applied to address polypharmacy, particularly among older adults. However, the characteristics of deprescribing that are likely to improve health outcomes have not been well studied. This study explored the experiences and perspectives of general practitioners and pharmacists with regard to deprescribing in older adults with multimorbidity. A qualitative study was conducted involving eight semi-structured focus group interviews with 35 physicians and pharmacists from hospitals, clinics, and community pharmacies. Thematic analysis was applied to identify themes using the theory of planned behavior as a guide. The results illustrated a metacognitive process, as well as influencing factors, through which healthcare providers commit to shared decision making for deprescribing. Healthcare providers acted on the basis of their attitudes and beliefs on deprescribing, the influence of subjective norms, and perceived behavioral control for deprescribing. These processes are influenced by factors such as drug class, prescribers, patients, deprescribing experience, and environment/education. Healthcare providers’ attitudes, beliefs, and behavioral control (along with deprescribing strategies) evolve in a dynamic interplay with experience, environment, and education. Our results can serve as a foundation for the development of effective patient-centered deprescribing to improve the safety of pharmaceutical care for older adults.

Keywords: polypharmacy; deprescribing; potentially inappropriate medication (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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