Role of nurses in supporting proactive deprescribing

Area of Science:

• Pharmacology
• Geriatrics
• Health Services Research

Background:

• Deprescribing involves stopping medications, either reactively (due to adverse events) or proactively (when benefits no longer outweigh harms).
• Current proactive deprescribing is limited in primary and secondary care settings.
• This article addresses the need for increased proactive deprescribing.

Purpose of the Study:

• Provide the rationale for enhancing proactive deprescribing initiatives.
• Identify specific medications suitable for proactive deprescribing.
• Explore barriers and enablers for implementing proactive deprescribing.
• Define the role of nurses in facilitating proactive deprescribing.

Main Methods:

• Literature review and synthesis of current evidence on deprescribing.
• Analysis of factors influencing the adoption of proactive deprescribing strategies.
• Discussion of clinical scenarios and medication classes relevant to proactive deprescribing.
• Framework development for nursing involvement in deprescribing.

Main Results:

• Limited current proactive deprescribing activity necessitates a strategic increase.
• Specific medication classes and patient populations are identified for proactive deprescribing.
• Key barriers include prescriber habits and patient adherence.
• Enablers involve patient education and multidisciplinary team support.

Conclusions:

• Increasing proactive deprescribing is crucial for optimizing patient outcomes and reducing medication-related harm.
• Nurses are pivotal in implementing proactive deprescribing through patient assessment, education, and collaboration.
• Further research and policy changes are needed to support widespread proactive deprescribing.