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- W4322758021 abstract "Abstract Objective Proactive deprescribing – identifying and discontinuing medicines where harms outweigh benefits – can minimise problematic polypharmacy, but has yet to be implemented into routine practice. Normalisation process theory (NPT) can provide a theory-informed understanding of the evidence base on what impedes or facilitates the normalisation of routine and safe deprescribing in primary care. This study systematically reviews the literature to identify barriers and facilitators to implementing routine safe deprescribing in primary care and their effect on normalisation potential using NPT. PubMed, MEDLINE, Embase, Web of Science, International Pharmaceutical Abstracts, CINAHL, PsycINFO and The Cochrane Library were searched (1996–2022). Studies of any design investigating the implementation of deprescribing in primary care were included. The Mixed Methods Appraisal Tool and the Quality Improvement Minimum Quality Criteria Set were used to appraise quality. Barriers and facilitators from included studies were extracted and mapped to the constructs of NPT. Key findings A total of 12,027 articles were identified, 56 articles included. In total, 178 barriers and 178 facilitators were extracted and condensed into 14 barriers and 16 facilitators. Common barriers were negative deprescribing perceptions and suboptimal deprescribing environments, while common facilitators were structured education and training on proactive deprescribing and utilising patient-centred approaches. Very few barriers and facilitators were associated with reflexive monitoring, highlighting a paucity of evidence on how deprescribing interventions are appraised. Summary Through NPT, multiple barriers and facilitators were identified that impede or facilitate the implementation and normalisation of deprescribing in primary care. However, more research is needed into the appraisal of deprescribing post-implementation." @default.
- W4322758021 created "2023-03-03" @default.
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- W4322758021 creator A5053366585 @default.
- W4322758021 creator A5075157702 @default.
- W4322758021 date "2023-03-01" @default.
- W4322758021 modified "2023-10-18" @default.
- W4322758021 title "Barriers and facilitators of implementing proactive deprescribing within primary care: a systematic review" @default.
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- W4322758021 doi "https://doi.org/10.1093/ijpp/riad001" @default.
- W4322758021 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/36860190" @default.
- W4322758021 hasPublicationYear "2023" @default.
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