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

Author

Listed:
  • Kenya Ie

    (Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
    Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki 214-8525, Japan
    Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15621, USA)

  • Reiko Machino

    (Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
    Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, 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
    Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo 105-8461, Japan)

  • Mio Kushibuchi

    (Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
    Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki 214-8525, Japan)

  • Masanori Hirose

    (Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan
    Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, 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
    Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki 214-8525, Japan)

  • Yoshiyuki Ohira

    (Department of General Internal Medicine, St. Marianna University School of Medicine, Kawasaki 214-8525, Japan)

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.

Suggested Citation

  • Kenya Ie & Reiko Machino & Steven M. Albert & Shiori Tomita & Mio Kushibuchi & Masanori Hirose & Takahide Matsuda & Chiaki Okuse & Yoshiyuki Ohira, 2023. "Deprescribing as an Opportunity to Facilitate Patient-Centered Care: A Qualitative Study of General Practitioners and Pharmacists in Japan," IJERPH, MDPI, vol. 20(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:3543-:d:1071529
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    References listed on IDEAS

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    1. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
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