Community pharmacists as catalysts for deprescribing: An exploratory study using quality improvement processes

Area of Science:

• Pharmacology
• Geriatrics
• Health Services Research

Background:

• Growing international focus on deprescribing, the reduction or cessation of medications.
• Elderly individuals are a key population benefiting from deprescribing due to potential harm outweighing benefits.
• Community pharmacists are strategically positioned to facilitate deprescribing initiatives.

Purpose of the Study:

• To enhance community pharmacists' ability to incorporate deprescribing into their routine practice.
• To develop effective training and workflow strategies for pharmacist-led deprescribing.
• To explore the feasibility and implementation of deprescribing services in community pharmacy settings.

Main Methods:

• Exploratory mixed-methods design, primarily qualitative.
• Training provided to pharmacy staff on deprescribing guidelines.
• Data collection through observations, advisory meetings, and Plan-Do-Study-Act (PDSA) cycles.
• Quantitative process and output measures analyzed.

Main Results:

• All participating pharmacies established deprescribing goals, though specific approaches varied.
• Deprescribing activities were successfully integrated into daily workflows.
• Key themes included staff capacity building, patient interaction strategies, medication reviews, and follow-up processes.
• Pharmacy approaches evolved over time through iterative PDSA cycles.

Conclusions:

• Deprescribing is a feasible service within community pharmacy settings.
• The study informed the development of a business model for implementing deprescribing services.
• Further development of business models is recommended to support widespread deprescribing adoption.