Exploring the need for a clinical decision support system for deprescribing - A qualitative interview study

Area of Science:

• Clinical Pharmacy
• Health Informatics
• Geriatric Medicine

Background:

• Deprescribing, the discontinuation of inappropriate medications, is crucial but lacks adequate education, support, and guidelines.
• Clinical Decision Support Systems (CDSS) enhance care quality by integrating medical knowledge with patient data for recommendations.

Purpose of the Study:

• To assess the necessity of developing a CDSS specifically for medication deprescribing.
• To identify obstacles hindering deprescribing practices.
• To determine the requirements of potential users for a deprescribing CDSS.

Main Methods:

• Qualitative study employing semistructured interviews with 10 physicians across geriatrics, primary care, and internal medicine in Sweden.
• Interviews utilized a predefined guide focusing on deprescribing challenges and the need for a CDSS.
• Empirical data analyzed using qualitative content analysis.

Main Results:

• Physicians highlighted significant challenges in deprescribing medications.
• A CDSS knowledge database requires careful design for clinical practice usability.
• Physicians require fast, simple, up-to-date, synthesized information from reliable sources, ideally integrated into electronic health records.

Conclusions:

• A clear need exists for a CDSS to support medication deprescribing.
• The absence of guidelines and support represents a major obstacle to deprescribing.
• The study provides valuable insights into physicians' perspectives on deprescribing medication.