Exploring deprescribing opportunities for community pharmacists using the Behaviour Change Wheel

Area of Science:

• Pharmacology
• Health Services Research
• Qualitative Research

Background:

• Deprescribing, the process of reducing or stopping medications, aims to minimize harm from unnecessary drug use.
• Implementing deprescribing is complex for both patients and healthcare providers.
• The potential role of community pharmacists in deprescribing initiatives requires further investigation.

Purpose of the Study:

• To investigate the current involvement of community pharmacists in deprescribing practices.
• To identify effective strategies for improving and expanding pharmacists' contributions to deprescribing.

Main Methods:

• Qualitative telephone interviews were conducted with 17 community pharmacists in Ontario, Canada.
• The Behaviour Change Wheel's COM-B model guided interview question development.
• Inductive thematic analysis was employed, with initial coding by multiple investigators and subsequent analysis informed by the Behaviour Change Wheel.

Main Results:

• Pharmacist engagement in deprescribing is influenced by their knowledge of appropriate medications for discontinuation, access to patient health information, and competing clinical and operational demands.
• Key barriers include understanding which medications to stop, patient information accessibility, and daily practice pressures.
• Recommendations focus on defining the pharmacist's role, enhancing their understanding of deprescribing integration, and engaging multiple stakeholders.

Conclusions:

• This study provides novel insights into real-world challenges faced by community pharmacists in deprescribing.
• Theory-informed recommendations are presented to optimize pharmacist involvement in deprescribing.
• Findings highlight the need for structured approaches and collaboration to enhance community pharmacists' contributions to deprescribing.