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Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey

PURPOSE: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and...

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Autores principales: van Poelgeest, Eveline P., Seppala, Lotta J., Lee, Jihoo M., Bahat, Gülistan, Ilhan, Birkan, Lavan, Amanda H., Mair, Alpana, van Marum, Rob J., Onder, Graziano, Ryg, Jesper, Fernandes, Marília Andreia, Garfinkel, Doron, Guðmundsson, Aðalsteinn, Hartikainen, Sirpa, Kotsani, Marina, Montero-Errasquín, Beatriz, Neumann-Podczaska, Agnieszka, Pazan, Farhad, Petrovic, Mirko, Soulis, George, Vankova, Hana, Wehling, Martin, Wieczorowska–Tobis, Katarzyna, van der Velde, Nathalie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722796/
https://www.ncbi.nlm.nih.gov/pubmed/36319837
http://dx.doi.org/10.1007/s41999-022-00702-9
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author van Poelgeest, Eveline P.
Seppala, Lotta J.
Lee, Jihoo M.
Bahat, Gülistan
Ilhan, Birkan
Lavan, Amanda H.
Mair, Alpana
van Marum, Rob J.
Onder, Graziano
Ryg, Jesper
Fernandes, Marília Andreia
Garfinkel, Doron
Guðmundsson, Aðalsteinn
Hartikainen, Sirpa
Kotsani, Marina
Montero-Errasquín, Beatriz
Neumann-Podczaska, Agnieszka
Pazan, Farhad
Petrovic, Mirko
Soulis, George
Vankova, Hana
Wehling, Martin
Wieczorowska–Tobis, Katarzyna
van der Velde, Nathalie
author_facet van Poelgeest, Eveline P.
Seppala, Lotta J.
Lee, Jihoo M.
Bahat, Gülistan
Ilhan, Birkan
Lavan, Amanda H.
Mair, Alpana
van Marum, Rob J.
Onder, Graziano
Ryg, Jesper
Fernandes, Marília Andreia
Garfinkel, Doron
Guðmundsson, Aðalsteinn
Hartikainen, Sirpa
Kotsani, Marina
Montero-Errasquín, Beatriz
Neumann-Podczaska, Agnieszka
Pazan, Farhad
Petrovic, Mirko
Soulis, George
Vankova, Hana
Wehling, Martin
Wieczorowska–Tobis, Katarzyna
van der Velde, Nathalie
author_sort van Poelgeest, Eveline P.
collection PubMed
description PURPOSE: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing. Responses to the survey questions and participant characteristics were quantified and differences evaluated between geriatricians and geriatricians-in-training and between European regions. RESULTS: The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) were generally willing to deprescribe (98%) and felt confident about deprescribing (85%). Despite differences across European regions, the most commonly reported reasons for deprescribing were functional impairment and occurrence of adverse drug reactions. The most important barriers for deprescribing were patients’ unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Perceived risk of adverse drug reactions was highest for psychotropic drugs, nonsteroidal anti-inflammatory drugs, cardiovascular drugs, and opioid analgesics. Only one in four respondents (23% of geriatricians and 37% of geriatricians-in-training) think education in medical school had sufficiently prepared them for deprescribing in clinical practice. They reported that their future deprescribing activities would probably increase with improved information sharing between various prescribers, deprescribing recommendations in guidelines, and increased education and training. Approximately 90% think that a paradigm shift is required for prescribers and patients, increasing focus on the possible benefits of deprescribing (potentially) inappropriate medications. CONCLUSIONS: Based on the outcomes of this survey, we recommend investing in improved inter-professional communication, better education and evidence-based recommendations to improve future patient-centered deprescribing practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41999-022-00702-9.
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spelling pubmed-97227962022-12-07 Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey van Poelgeest, Eveline P. Seppala, Lotta J. Lee, Jihoo M. Bahat, Gülistan Ilhan, Birkan Lavan, Amanda H. Mair, Alpana van Marum, Rob J. Onder, Graziano Ryg, Jesper Fernandes, Marília Andreia Garfinkel, Doron Guðmundsson, Aðalsteinn Hartikainen, Sirpa Kotsani, Marina Montero-Errasquín, Beatriz Neumann-Podczaska, Agnieszka Pazan, Farhad Petrovic, Mirko Soulis, George Vankova, Hana Wehling, Martin Wieczorowska–Tobis, Katarzyna van der Velde, Nathalie Eur Geriatr Med Research Paper PURPOSE: To provide an overview of the current deprescribing attitudes, practices, and approaches of geriatricians and geriatricians-in-training across Europe. METHODS: An online survey was disseminated among European geriatricians and geriatricians-in-training. The survey comprised Likert scale and multiple-choice questions on deprescribing approaches and practices, deprescribing education and knowledge, and facilitators/barriers of deprescribing. Responses to the survey questions and participant characteristics were quantified and differences evaluated between geriatricians and geriatricians-in-training and between European regions. RESULTS: The 964 respondents (median age 42 years old; 64% female; 21% geriatricians-in-training) were generally willing to deprescribe (98%) and felt confident about deprescribing (85%). Despite differences across European regions, the most commonly reported reasons for deprescribing were functional impairment and occurrence of adverse drug reactions. The most important barriers for deprescribing were patients’ unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Perceived risk of adverse drug reactions was highest for psychotropic drugs, nonsteroidal anti-inflammatory drugs, cardiovascular drugs, and opioid analgesics. Only one in four respondents (23% of geriatricians and 37% of geriatricians-in-training) think education in medical school had sufficiently prepared them for deprescribing in clinical practice. They reported that their future deprescribing activities would probably increase with improved information sharing between various prescribers, deprescribing recommendations in guidelines, and increased education and training. Approximately 90% think that a paradigm shift is required for prescribers and patients, increasing focus on the possible benefits of deprescribing (potentially) inappropriate medications. CONCLUSIONS: Based on the outcomes of this survey, we recommend investing in improved inter-professional communication, better education and evidence-based recommendations to improve future patient-centered deprescribing practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41999-022-00702-9. Springer International Publishing 2022-11-02 2022 /pmc/articles/PMC9722796/ /pubmed/36319837 http://dx.doi.org/10.1007/s41999-022-00702-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Paper
van Poelgeest, Eveline P.
Seppala, Lotta J.
Lee, Jihoo M.
Bahat, Gülistan
Ilhan, Birkan
Lavan, Amanda H.
Mair, Alpana
van Marum, Rob J.
Onder, Graziano
Ryg, Jesper
Fernandes, Marília Andreia
Garfinkel, Doron
Guðmundsson, Aðalsteinn
Hartikainen, Sirpa
Kotsani, Marina
Montero-Errasquín, Beatriz
Neumann-Podczaska, Agnieszka
Pazan, Farhad
Petrovic, Mirko
Soulis, George
Vankova, Hana
Wehling, Martin
Wieczorowska–Tobis, Katarzyna
van der Velde, Nathalie
Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title_full Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title_fullStr Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title_full_unstemmed Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title_short Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey
title_sort deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across europe: a large web-based survey
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722796/
https://www.ncbi.nlm.nih.gov/pubmed/36319837
http://dx.doi.org/10.1007/s41999-022-00702-9
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