IF 3.3 Q1 HEALTH POLICY & SERVICES Journal of Pharmaceutical Policy and Practice Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.1080/20523211.2024.2399727
Chee Tao Chang, Huan-Keat Chan, Ewilly Jie Ying Liew, Muhammad Radzi Abu Hassan, Jason Choong Yin Lee, Wee Kooi Cheah, Xin Jie Lim, Philip Rajan, Siew Li Teoh, Shaun Wen Huey Lee
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引用次数: 0

摘要

简介去处方化是缓解多种药物导致的药物相关问题的关键措施。本研究旨在利用 "行为改变轮"(Behaviour Change Wheel)框架绘制影响医疗服务提供者开具处方决定的因素图,并开发一个创新的概念模型,以支持开具处方的实践:方法:针对医生和药剂师开展了一项横断面在线调查,以评估各种因素对医疗服务提供者是否乐于建议去药瘾的影响。根据现有的去处方化框架和行为改变轮,制定了概念模型。通过偏最小二乘法结构方程模型(PLS-SEM)对模型的稳健性进行了检验,并采用了模型拟合指数来获得最佳拟合模型:结果:共分析了 736 个回答,最终得出的最佳拟合模型包括 5 个结构中的 24 个项目(R 2:0.163;SRMR:0.064;rho_c:0.750-0.862;AVE:0.509-0.627)和 3 个独立因子。根据研究结果,我们提出,可以通过旨在提高医疗服务提供者内部能力(如知识水平、患者病情恶化时的知识水平以及以往药物不良事件的经验)的策略来促进去处方化。提供此类教育机会的组织支持非常重要,通过政策改进、指南制定和有效沟通来增强患者和医疗服务提供者的能力:医疗保健专业人员的去处方行为受到患者、处方者和系统因素错综复杂的相互作用的影响。加强去处方化实践需要采取全面的策略,包括对医疗服务提供者和患者进行教育、制定结构化的去处方化指南、实施去处方化支持工具以及加强医疗服务提供者之间的沟通。
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Factors influencing healthcare providers' behaviours in deprescribing: a cross-sectional study.

Introduction: Deprescribing serves as a pivotal measure to mitigate the drug-related problem due to polypharmacy. This study aimed to map the factors influencing healthcare providers' deprescribing decision using the Behaviour Change Wheel framework and develop an innovative conceptual model to support deprescribing practice.

Methods: A cross-sectional online survey targeting doctors and pharmacists was conducted to assess the influence of various factors on healthcare providers' comfort in recommending deprescribing. The conceptual model was formulated, based on the existing deprescribing framework and the Behaviour Change Wheel. The model's robustness was scrutinised through Partial Least Squares Structural Equation Modeling (PLS-SEM), and model-fitting indices were employed to obtain the best-fit model.

Results: A total of 736 responses were analysed with the final best-fit model consisting of 24 items in 5 constructs (R 2: 0.163; SRMR: 0.064; rho_c: 0.750-0.862; AVE: 0.509-0.627) and three independent factors. Based on the results, we proposed that deprescribing could be promoted through strategies aimed at enhancing healthcare providers internal capabilities such as knowledge levels, when patients' condition deteriorated and previous experiences with adverse events of drugs. Organisational support in providing such educational opportunities is important, with the empowerment of patient and healthcare providers through policy enhancements, guideline development, and effective communication.

Conclusion: The deprescribing behaviours of healthcare professionals are influenced by an intricate interplay of patient, prescriber, and system factors. Enhancing deprescribing practices necessitates a comprehensive strategy that encompasses providers and patients' education, the development of structured deprescribing guidelines, the implementation of deprescribing support tools, and the enhancement of communication between healthcare providers.

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来源期刊
Journal of Pharmaceutical Policy and Practice
Journal of Pharmaceutical Policy and Practice Health Professions-Pharmacy
CiteScore
4.70
自引率
9.50%
发文量
81
审稿时长
14 weeks
期刊最新文献
Association of anxiolytic drugs with Torsade de Pointes: a pharmacovigilance study of the Food and Drug Administration Adverse Event Reporting System. Factors influencing healthcare providers' behaviours in deprescribing: a cross-sectional study. Good manufacturing practice inspections conducted by Tanzania medicines and medical devices authority: a comparative study of two fiscal years from 2018 to 2020. Unused medicine take-back programmes: a systematic review. Community pharmacy & primary care integration: qualitative study on stakeholders' opinions and interventions.
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