Deprescribing for older adults in Australia: factors influencing GPs
Robyn Gillespie
A D , Judy Mullan A B and Lindsey Harrison C
+ Author Affiliations
- Author Affiliations
A School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.
B Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute, iC Enterprise 1, Innovation Campus, University of Wollongong, Wollongong, NSW 2522, Australia.
C School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
D Corresponding author. Email: rjg906@uowmail.edu.au
Australian Journal of Primary Health 24(6) 463-469 https://doi.org/10.1071/PY18056
Submitted: 28 March 2018 Accepted: 17 July 2018 Published: 14 November 2018
Abstract
Polypharmacy is increasing among older Australians, raising their risk of experiencing medication-related harm. As part of the prescribing continuum, deprescribing is a strategy proposed to reduce inappropriate polypharmacy. This study explored factors that influence deprescribing among Australian GPs using a new 21-item survey to measure GP attitudes and practices. The 85 GP responses indicated that many factors are supportive of deprescribing. GPs suggest that they are willing to explore their older patients’ deprescribing preferences; they believe that they have enough information about the potential harms and benefits of medication to inform their deprescribing decisions and are confident to communicate this information to their patients. GPs did not consider their patients would interpret deprescribing as being ‘given up on’. Limited time to review medications, poor communication between prescribers and a perception that other prescribers do not respect their role as overall coordinators of their older patients’ medications were considered by respondents to be unsupportive of deprescribing. Overall, despite GPs reporting many supportive factors for deprescribing, the influence of unsupportive factors appears to remain strong, as deprescribing is not routinely considered in practice.
Additional keywords: family physician, medication management, multiple morbidity, polypharmacy.
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