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Deprescribing practice in a resource-limited setting: Healthcare providers’ insights
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  • Henok Tegegn ,
  • Begashaw Melaku Gebresillassie,
  • Daniel Asfaw ERKU ,
  • Asrat ELIAS ,
  • Abdella Birhan YABEYU,
  • Asnakew Achaw AYELE
Henok Tegegn
University of Gondar
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Begashaw Melaku Gebresillassie
University of Gondar
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Daniel Asfaw ERKU
The University of Queensland School of Pharmacy
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Asrat ELIAS
University of Gondar
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Abdella Birhan YABEYU
Addis Ababa University College of Health Sciences
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Asnakew Achaw AYELE
University of Gondar
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Abstract

Aims: Inappropriate polypharmacy poses adverse drug events, mortality, and high healthcare costs. Deprescribing could minimise inappropriate polypharmacy and the consequence thereof. This study aims to evaluate healthcare providers’ (HCPs) attitudes toward, and experiences with the deprescribing practice. Methods: An institution-based cross-sectional study was conducted among HCPs at the University of Gondar Referral Hospital, Ethiopia. Perception of HCPs on deprescribing was measured by Linsky et al. validated tool. This tool has five dimensions that could affect HCPs’ decision to discontinue medications intentionally. One-way ANOVA was used to test the association between socio-demographic variables and their perception of deprescribing decisions. Results: Of 85 HCPs approached, about 82 HCPs with a 96.5% response rate were included in the final analysis of this study. Most HCPs (87%) were less likely or not at all to be affected by a strong relationship between HCPs and their patients to make a deprescribing decision. However, HCPs believed that formal education, significant physical health conditions, objective response to the clinical endpoint of the medication (e.g., blood pressure), and on-the-job experience profoundly influenced them to decide on deprescribing. According to the post-hoc analysis of one-way ANOVA, clinical pharmacists seemed to have a better attitude toward deprescribing decisions compared to physicians. (p = 0.025). Conclusion: HCPs’ decision to discontinue a medication could be multifactorial, and HCPs could be influenced by education level and their experience to discontinue a medication intentionally. A therapy-specific deprescribing algorithm, multidisciplinary collaboration, and continuous education development should be instituted to guide HCPs in the deprescribing decision process.

Peer review status:ACCEPTED

09 Aug 2020Submitted to International Journal of Clinical Practice
13 Aug 2020Assigned to Editor
13 Aug 2020Submission Checks Completed
22 Sep 2020Reviewer(s) Assigned
06 Nov 2020Review(s) Completed, Editorial Evaluation Pending
28 Dec 20201st Revision Received
30 Dec 2020Assigned to Editor
30 Dec 2020Submission Checks Completed
30 Dec 2020Reviewer(s) Assigned
26 Apr 2021Review(s) Completed, Editorial Evaluation Pending
06 May 20212nd Revision Received
06 May 2021Submission Checks Completed
06 May 2021Assigned to Editor
06 May 2021Review(s) Completed, Editorial Evaluation Pending
07 May 2021Editorial Decision: Accept