Assertiveness in community pharmacists and their experience of pharmacist-led deprescribing: A cross-sectional study.

Abstract

Background: Deprescribing by physicians based on the suggestions of community pharmacists is useful to ensure medication safety. Pharmacist-led deprescribing is not always implemented smoothly because of communication gaps between physicians and pharmacists. Our previous study found that assertiveness, as a communication style, is associated with pharmacist-initiated prescription changes for medication safety; however, its association with community pharmacist-led deprescribing is unclear.

Objectives: Our objective was to investigate which types of self-expression related to assertiveness are associated with community pharmacist-led deprescribing while adjusting for possible confounding factors.

Methods: We conducted a cross-sectional survey among community pharmacists between May and October 2022. Participants were community pharmacists belonging to a nationwide pharmacy chain in Japan who worked in 1 of 10 prefectures. The outcome variable was experience of community pharmacist-led deprescribing in the past year. Community pharmacists' self-expression related to assertiveness was assessed using the 3 subdomains of the Interprofessional Assertiveness Scale (IAS): nonassertive, assertive, and aggressive self-expression. Participants were classified into 1 of 2 categories based on median IAS subdomain scores. Pharmacist characteristics were compared by group in univariate analyses. Binomial logistic regression was used to examine the association between experience of community pharmacist-led deprescribing and community pharmacists' assertiveness.

Results: Of the 3346 community pharmacists invited, 963 were included in the analysis. After adjustment, high assertive self-expression was associated with experience of community pharmacist-led deprescribing (adjusted odds ratio, 1.49; 95 % confidence interval, 1.02-2.20; p = 0.042). No associations were found between experience of community pharmacist-led deprescribing and nonassertive or aggressive self-expression.

Conclusions: Community pharmacists with higher levels of assertive self-expression were more likely to experience community pharmacist-led deprescribing.