학술논문

Deprescribing medications among patients with multiple prescribers: A socioecological model.
Document Type
Article
Source
Journal of the American Geriatrics Society. Mar2024, Vol. 72 Issue 3, p660-669. 10p.
Subject
*DRUG overdose
*INAPPROPRIATE prescribing (Medicine)
*PATIENT compliance
*MEDICAL prescriptions
*DRUG side effects
*HEALTH
*DEPRESCRIBING
*POLYPHARMACY
*CONTINUUM of care
*INFORMATION resources
*PHYSICIAN practice patterns
*DRUG interactions
*MATHEMATICAL models
*DRUG prescribing
*THEORY
Language
ISSN
0002-8614
Abstract
Deprescribing is the intentional dose reduction or discontinuation of a medication. The development of deprescribing interventions should take into consideration important organizational, interprofessional, and patient‐specific barriers that can be further complicated by the presence of multiple prescribers involved in a patient's care. Patients who receive care from an increasing number of prescribers may experience disruptions in the timely transfer of relevant healthcare information, increasing the risk of exposure to drug–drug interactions and other medication‐related problems. Furthermore, the fragmentation of healthcare information across health systems can contribute to the refilling of discontinued medications, reducing the effectiveness of deprescribing interventions. Thus, deprescribing interventions must carefully consider the unique characteristics of patients and their prescribers to ensure interventions are successfully implemented. In this special article, an international working group of physicians, pharmacists, nurses, epidemiologists, and researchers from the United States Deprescribing Research Network (USDeN) developed a socioecological model to understand how multiple prescribers may influence the implementation of a deprescribing intervention at the individual, interpersonal, organizational, and societal level. This manuscript also includes a description of the concept of multiple prescribers and outlines a research agenda for future investigations to consider. The information contained in this manuscript should be used as a framework for future deprescribing interventions to carefully consider how multiple prescribers can influence the successful implementation of the service and ensure the intervention is as effective as possible. [ABSTRACT FROM AUTHOR]