Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study
Objective To examine the determinants of deprescribing among health professionals in nursing homes, focusing on knowledge, practice and attitude.Design This was a qualitative study comprising semi-structured face-to-face interviews guided by 10 open-ended questions. Interviews were conducted until d...
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/10/e030106.full |
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| author | Shaun Wen Huey Lee Chong-Han Kua Vivienne SL Mak |
| author_facet | Shaun Wen Huey Lee Chong-Han Kua Vivienne SL Mak |
| author_sort | Shaun Wen Huey Lee |
| collection | DOAJ |
| description | Objective To examine the determinants of deprescribing among health professionals in nursing homes, focusing on knowledge, practice and attitude.Design This was a qualitative study comprising semi-structured face-to-face interviews guided by 10 open-ended questions. Interviews were conducted until data saturation was achieved and no new ideas were formed. The interviews were audio-recorded, transcribed verbatim and analysed for themes. To derive themes, we employed directed content analysis of transcript data. Coding was completed using a combination of open, axial and selective coding.Setting Four nursing homes in Singapore.Participants The study involved 17 participants (comprising 4 doctors, 4 pharmacists and 9 nurses).Results Two key themes were identified, enablers and challenges. These were enablers and challenges faced by doctors, pharmacists and nurses towards deprescribing. The identified subthemes for enablers of deprescribing were: (1) awareness of medications that are unnecessary or could be targeted for deprescribing; (2) improving quality of life for patients with limited life expectancy; (3) improving communication between doctors, pharmacists and nurses; (4) systematic deprescribing practice and educational tools and (5) acknowledgement of possible benefits of deprescribing. The identified subthemes for challenges of deprescribing were: (1) symptoms not acknowledged as possibly drug-related; (2) lack of knowledge in patient’s and family members’ preferences; (3) lack of coordination between health professionals in hospitals and nursing homes and (4) limited tools for deprescribing. The development of a local guideline, mentoring nurses, case discussions, better shared decision-making and improving multidisciplinary communication, may help to support the process of deprescribing.Conclusion In conclusion, this study highlighted that deprescribing in the nursing homes is perceived by health professionals to be challenging and future research could assess how routine case studies, mentoring and better multidisciplinary communication could improve deprescribing knowledge and process in the nursing homes. |
| format | Article |
| id | doaj-art-e7d18ba5e51e40329b2d5aeddd2de2d5 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e7d18ba5e51e40329b2d5aeddd2de2d52024-12-13T15:50:43ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-030106Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview studyShaun Wen Huey Lee0Chong-Han Kua1Vivienne SL Mak2School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia1 School of Pharmacy, Monash University—Malaysia Campus, Bandar Sunway, Malaysia3 Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University—Parkville Campus, Parkville, Victoria, AustraliaObjective To examine the determinants of deprescribing among health professionals in nursing homes, focusing on knowledge, practice and attitude.Design This was a qualitative study comprising semi-structured face-to-face interviews guided by 10 open-ended questions. Interviews were conducted until data saturation was achieved and no new ideas were formed. The interviews were audio-recorded, transcribed verbatim and analysed for themes. To derive themes, we employed directed content analysis of transcript data. Coding was completed using a combination of open, axial and selective coding.Setting Four nursing homes in Singapore.Participants The study involved 17 participants (comprising 4 doctors, 4 pharmacists and 9 nurses).Results Two key themes were identified, enablers and challenges. These were enablers and challenges faced by doctors, pharmacists and nurses towards deprescribing. The identified subthemes for enablers of deprescribing were: (1) awareness of medications that are unnecessary or could be targeted for deprescribing; (2) improving quality of life for patients with limited life expectancy; (3) improving communication between doctors, pharmacists and nurses; (4) systematic deprescribing practice and educational tools and (5) acknowledgement of possible benefits of deprescribing. The identified subthemes for challenges of deprescribing were: (1) symptoms not acknowledged as possibly drug-related; (2) lack of knowledge in patient’s and family members’ preferences; (3) lack of coordination between health professionals in hospitals and nursing homes and (4) limited tools for deprescribing. The development of a local guideline, mentoring nurses, case discussions, better shared decision-making and improving multidisciplinary communication, may help to support the process of deprescribing.Conclusion In conclusion, this study highlighted that deprescribing in the nursing homes is perceived by health professionals to be challenging and future research could assess how routine case studies, mentoring and better multidisciplinary communication could improve deprescribing knowledge and process in the nursing homes.https://bmjopen.bmj.com/content/9/10/e030106.full |
| spellingShingle | Shaun Wen Huey Lee Chong-Han Kua Vivienne SL Mak Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study BMJ Open |
| title | Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study |
| title_full | Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study |
| title_fullStr | Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study |
| title_full_unstemmed | Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study |
| title_short | Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study |
| title_sort | perspectives of health professionals towards deprescribing practice in asian nursing homes a qualitative interview study |
| url | https://bmjopen.bmj.com/content/9/10/e030106.full |
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