Barriers to Deprescribing in Everyday Practice Explored

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Doctors describe swimming against tide of patient expectations, Rx culture, organizational constraints
Doctors describe swimming against tide of patient expectations, Rx culture, organizational constraints

HealthDay News — Organizational changes are recommended by primary care physicians to support safer prescribing, according to a study published in the July/August issue of the Annals of Family Medicine.

Katharine A. Wallis, MB, ChB, PhD, from the University of Auckland in New Zealand, and colleagues identified potential physician participants using a snowball sampling technique. Emergent themes were identified from 24 semi-structured interventions that were recorded, transcribed, and analyzed. 

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The researchers note that physicians described swimming against the tide of patient expectations, the culture of prescribing, and organizational constraints. Deprescribing was associated with inherent risks for themselves and patients, and indicated a sense of vulnerability. A sense of duty to do what was right for the patient was the only incentive for deprescribing. Targeted funding for annual medicines review, computer prompts, improved between-prescriber information flow, improved access to expert advice and user-friendly decision support, increased availability of non-pharmaceutical therapies, and enhanced patient engagement in medicines management were recommended organizational changes to support safer prescribing.

"Regulations and policies should be designed to support physicians in practicing according to their professional ethical values," the authors write.

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