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Shared decision making with breast cancer patients – does it work?
244 Deprescribing and shared decision-making research
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  1. Sion Scott1,
  2. Kristie Rebecca Weir2,3,
  3. Petra Denig4,
  4. Nagham Ailabouni5,
  5. María López-Toribio6,7
  1. 1School of Healthcare, College of Life Sciences, University of Leicester, UK
  2. 2Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
  3. 3Sydney School of Public Health, University of Sydney, Sydney, Australia
  4. 4Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  5. 5The Pharmacy Australian Centre of Excellence (PACE), School of Pharmacy, Health and Behavioural Sciences Faculty, University of Queensland, Brisbane, Queensland, Australia
  6. 6Clinical Pharmacy and Pharmacoepidemiology Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
  7. 7Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium

Abstract

Introduction Deprescribing, stopping a medication or dose reduction, should be in partnership between the prescriber who is the disease expert and the patient who is the expert on their illness.1 This symposium will describe the role of shared decision making in achieving deprescribing and interventions designed to augment patient involvement.

1. An internationally-derived best practice process of deprescribing steps, activities and determinants This study developed a specification validated by practitioners from multiple health systems that stipulates the requirements for safe deprescribing. We present the extent to which the activities are currently undertaken and identify the barriers and enablers that need addressing for safe deprescribing.

2. Exploring the different contexts of statin deprescribing A vignette-based online experimental study was conducted with older adults (n=4,873) aged ≥65 years from Australia, the Netherlands, the UK, and the US. The manipulation involved scenarios (specialist prescriber, lifestyle changes, family preference) which influenced participants’ levels of agreement with deprescribing simvastatin.

3. Eliciting patients’ preferences for deprescribing cardiovascular and diabetes medication Based on studies exploring barriers to deprescribing, a multicomponent communication training for primary care teams conducting medication reviews was developed and tested. The training elements aim to involve older frail patients in decisions on reducing their cardiovascular and diabetes medication.

4. A conversation tool to empower people living with dementia to make shared deprescribing decisions with their prescriber Co-designed with a diverse stakeholder steering group from Australia and the US, the tool was tested extensively with 55 consumers and 11 healthcare professionals (pharmacists, geriatricians).

5. Patient Reported Experience Measure (PREM) on deprescribing Benzodiazepines and Sedative-Hypnotics Benzodiazepines and sedative-hypnotics may cause significant harm for older patients. This PREM was developed to assess the level of patient involvement during deprescribing and decision-making to improve the quality of patient care.

Reference

  1. Jansen J, Naganathan V, Carter SM, McLachlan AJ, Nickel B, et al. Too much medicine in older people? Deprescribing through shared decision making. Bmj. 2016 Jun 3;353.

https://doi.org/10.1136/bmjebm-2024-SDC.243

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