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Basic & clinical pharmacology & toxicology. 2025 Jul;137(1):e70060. doi: 10.1111/bcpt.70060 Q32.72024

Barriers and Facilitators to Pharmacist-Led Deprescribing of Antihypertensives in Long-Term Care: A Survey-Based Study

长期护理中药师主导的降压药减药的障碍与促进因素:基于调查的研究 翻译改进

Ana Vucenovic  1, Roni Y Kraut  1, Donna P Manca  1, Cheryl A Sadowski  2

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作者单位

  • 1 Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • 2 Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.
  • DOI: 10.1111/bcpt.70060 PMID: 40495094

    摘要 中英对照阅读

    Pharmacist-led deprescribing is an approach of addressing polypharmacy in the long-term care (LTC) setting. However, the sustainability of this practice has not been widely studied. This study describes facilitators and barriers to pharmacist-led deprescribing from pre- and post-surveys completed as part of a randomized controlled antihypertensive deprescribing trial in Alberta, Canada. The surveys, targeting facilitators and barriers to deprescribing, were developed based on current evidence and designed through an iterative process with pharmacist input and consist of open- and closed-ended questions. Nine pharmacists completed both surveys (seven female; five have been a pharmacist ≥10 years; and eight had their Additional Prescribing Authority [authority to prescribe to full scope of practice]). The key facilitators were (1) pharmacist confidence and attitude toward deprescribing, (2) sufficient patient data, and (3) minimal tools and education required. The key barriers included (1) pharmacist perception of not being the primary decision maker on prescribing decisions, (2) insufficient support from residents' families and physicians, and (3) additional time required. These facilitators and barriers were all identified pre-deprescribing, and confirmed, and more evident post-deprescribing. These barriers will make it challenging for pharmacists to incorporate deprescribing antihypertensives into routine care.

    Keywords: antihypertensives; deprescribing; long‐term care; pharmacist; polypharmacy.

    Keywords:pharmacist-led deprescribing; antihypertensives; long-term care; barriers and facilitators

    药师主导的停药是一种在长期护理(LTC)环境中解决多重用药问题的方法。然而,这种实践的可持续性尚未得到广泛研究。本研究描述了来自加拿大阿尔伯塔省进行的一项随机对照降压药物减量试验前后调查中识别出的促进因素和障碍。这些调查旨在针对影响停药的因素,基于现有证据设计,并通过与药师的多次讨论迭代完成。这些问题包括开放式和封闭式问题。九名药师完成了这两份调查(七名为女性;五人从事药师职业超过10年;八人拥有额外处方权[有权开具全部范围内的药物])。关键促进因素为:(1)药师对停药的信心和态度,(2)足够的患者数据,以及(3)所需的工具和教育较少。关键障碍包括:(1)药师认为自己不是主要的开药决策者,(2)来自居民家属和支持不足,以及(3)需要额外的时间。这些促进因素和障碍都在实施停药之前被识别,并且在执行之后得到了确认,并更加明显了。这些障碍将使药师难以将其纳入日常护理中。

    关键词:抗高血压药物;减药;长期护理;药师;多重用药。

    © 2025 The Author(s). Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

    关键词:药师主导的去处方化; 降压药; 长期护理; 障碍与促进因素

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    ISSN:1742-7835

    e-ISSN:1742-7843

    IF/分区:2.7/Q3

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