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This article discusses the problem of overprescribing medications to older adults and the lack of routine deprescribing practices. Deprescribing is a complex process that requires behavior change from healthcare professionals. The article emphasizes the need for interventions that address all key determinants of deprescribing and suggests using logic models to visually depict interventions and their effects. It also highlights the importance of understanding the context in which behavior change interventions are implemented and evaluating fidelity and outcomes. The article concludes by calling for consistency and adherence to a defined pathway for developing and evaluating complex interventions. [Extracted from the article]

Deprescribing is the process of stopping medication that may no longer be necessary or is causing harm. There has been a significant amount of research on deprescribing in the past decade, covering topics such as deprescribing rates, barriers and facilitators, and interventions. A group of deprescribing experts compiled a list of ten articles that provide a diverse overview of the field for newcomers. The articles cover critical concepts, high-level overviews, major trials, the complexity of deprescribing, and knowledge synthesis in deprescribing. While the list is not exhaustive, it serves as a starting point for those interested in learning about deprescribing. [Extracted from the article]

Aims: The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods: From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years’ experience as a pharmacist and as a prescriber). Results: Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion: Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature. [ABSTRACT FROM AUTHOR]

SPECIFYING WHOSE BEHAVIOUR NEEDS TO CHANGE Both practitioner and patient behaviour are key to successful proactive deprescribing, and interventions targeting both have been developed. Whilst the practitioner is the recipient of the behaviour change intervention, the patient is the recipient of the resulting practitioner behaviour. Patients want practitioners to initiate the process, yet over a decade of research endeavour has been divided between practitioner and patient behaviour change. [Extracted from the article]