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Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study

OBJECTIVE: To develop information leaflets for older inpatients and/or their carers to support deprescribing of antipsychotics, benzodiazepines/Z-drugs and proton pump inhibitors (PPIs). DESIGN: An iterative mixed-methods approach involving face-to-face user testing and semi-structured interviews wa...

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Autores principales: Jokanovic, Natali, Aslani, Parisa, Carter, Sophie, Duong, Mai, Gnjidic, Danijela, Jansen, Jesse, Le Couteur, David, Hilmer, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924866/
https://www.ncbi.nlm.nih.gov/pubmed/31831548
http://dx.doi.org/10.1136/bmjopen-2019-033303
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author Jokanovic, Natali
Aslani, Parisa
Carter, Sophie
Duong, Mai
Gnjidic, Danijela
Jansen, Jesse
Le Couteur, David
Hilmer, Sarah
author_facet Jokanovic, Natali
Aslani, Parisa
Carter, Sophie
Duong, Mai
Gnjidic, Danijela
Jansen, Jesse
Le Couteur, David
Hilmer, Sarah
author_sort Jokanovic, Natali
collection PubMed
description OBJECTIVE: To develop information leaflets for older inpatients and/or their carers to support deprescribing of antipsychotics, benzodiazepines/Z-drugs and proton pump inhibitors (PPIs). DESIGN: An iterative mixed-methods approach involving face-to-face user testing and semi-structured interviews was performed over three rounds with consumers and hospital health professionals. SETTING: Sydney, New South Wales, Australia. PARTICIPANTS: Thirty-seven consumers (or their carers) aged 65 years or older admitted to hospital in the previous 5 years and taking at least one regular medicine (not the medicine tested) completed user testing. Health professionals included a convenience sample of seven pharmacists and five doctors. METHODS: The antipsychotic leaflet was tested in round 1 (consumers, n=10) and revised and retested in round 2 (consumers, n=9; health professionals, n=5). Findings from rounds 1 and 2 informed the design of the benzodiazepine/Z-drug and PPI leaflets tested in round 3 (benzodiazepine/Z-drug consumers, n=9; health professionals, n=7; PPI consumers, n=9). Findings from round 3 informed the final design of all leaflets. Consumer user testing involved 12–13 questions to evaluate consumers’ ability to locate and understand information in the leaflet. Usability by health professionals was assessed using the System Usability Scale (SUS). RESULTS: At least 80% of consumers correctly found and understood the deprescribing information in the leaflets (9 of 12 information points in round 1 (antipsychotic); 10 of 12 in round 2; 12 of 13 (benzodiazepine/Z-drug) and 11 of 12 (PPI) in round 3). Consumers perceived the leaflets to be informative, well-designed and useful aids for ongoing medication management. The SUS scores obtained from health professionals were 91.0±3.8 for the antipsychotic leaflet and 86.4±6.6 for the benzodiazepine/Z-drug leaflet, indicating excellent usability. CONCLUSIONS: Understandable and easy-to-use consumer information leaflets were developed and tested by consumers and health professionals. The feasibility and utility of these leaflets to support deprescribing at transitions of care should be explored in clinical practice.
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spelling pubmed-69248662020-01-03 Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study Jokanovic, Natali Aslani, Parisa Carter, Sophie Duong, Mai Gnjidic, Danijela Jansen, Jesse Le Couteur, David Hilmer, Sarah BMJ Open Geriatric Medicine OBJECTIVE: To develop information leaflets for older inpatients and/or their carers to support deprescribing of antipsychotics, benzodiazepines/Z-drugs and proton pump inhibitors (PPIs). DESIGN: An iterative mixed-methods approach involving face-to-face user testing and semi-structured interviews was performed over three rounds with consumers and hospital health professionals. SETTING: Sydney, New South Wales, Australia. PARTICIPANTS: Thirty-seven consumers (or their carers) aged 65 years or older admitted to hospital in the previous 5 years and taking at least one regular medicine (not the medicine tested) completed user testing. Health professionals included a convenience sample of seven pharmacists and five doctors. METHODS: The antipsychotic leaflet was tested in round 1 (consumers, n=10) and revised and retested in round 2 (consumers, n=9; health professionals, n=5). Findings from rounds 1 and 2 informed the design of the benzodiazepine/Z-drug and PPI leaflets tested in round 3 (benzodiazepine/Z-drug consumers, n=9; health professionals, n=7; PPI consumers, n=9). Findings from round 3 informed the final design of all leaflets. Consumer user testing involved 12–13 questions to evaluate consumers’ ability to locate and understand information in the leaflet. Usability by health professionals was assessed using the System Usability Scale (SUS). RESULTS: At least 80% of consumers correctly found and understood the deprescribing information in the leaflets (9 of 12 information points in round 1 (antipsychotic); 10 of 12 in round 2; 12 of 13 (benzodiazepine/Z-drug) and 11 of 12 (PPI) in round 3). Consumers perceived the leaflets to be informative, well-designed and useful aids for ongoing medication management. The SUS scores obtained from health professionals were 91.0±3.8 for the antipsychotic leaflet and 86.4±6.6 for the benzodiazepine/Z-drug leaflet, indicating excellent usability. CONCLUSIONS: Understandable and easy-to-use consumer information leaflets were developed and tested by consumers and health professionals. The feasibility and utility of these leaflets to support deprescribing at transitions of care should be explored in clinical practice. BMJ Publishing Group 2019-12-11 /pmc/articles/PMC6924866/ /pubmed/31831548 http://dx.doi.org/10.1136/bmjopen-2019-033303 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Geriatric Medicine
Jokanovic, Natali
Aslani, Parisa
Carter, Sophie
Duong, Mai
Gnjidic, Danijela
Jansen, Jesse
Le Couteur, David
Hilmer, Sarah
Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title_full Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title_fullStr Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title_full_unstemmed Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title_short Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
title_sort development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study
topic Geriatric Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924866/
https://www.ncbi.nlm.nih.gov/pubmed/31831548
http://dx.doi.org/10.1136/bmjopen-2019-033303
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