Article Text

Download PDFPDF
004 Co-designing a consult patient decision aid for deprescribing cholinesterase inhibitors
  1. Nagham J Ailabouni1,
  2. Wade Thompson2,
  3. Sarah N Hilmer3,
  4. Q Lyntara4,
  5. M Uirke Janet5,
  6. Qcneece Alice Bourke5,
  7. Chloe Furst5,
  8. Emily Reeve6,7
  1. 1The Pharmacy Australian Centre of Excellence, University of Queensland, QLD, Australia
  2. 2Faculty of Medicine, The University of British Columbia
  3. 3Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia
  4. 4Consumer advocate, Dementia Australia
  5. 5Royal Adelaide Hospital, SA, Australia
  6. 6Centre of Medicine Use and Safety, Monash University, VIC, Australia
  7. 7Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, SA, Australia

Abstract

Introduction People living with dementia take many medications, some of which may become high-risk, unnecessary, or ineffective as dementia progresses. Up to one third of cholinesterase inhibitors (ChEIs) are continued for longer than appropriate. Deprescribing (reducing or stopping) these medications remains limited. Our aim was to co-design a consult patient decision aid (CPtDA) to support shared decision making between healthcare professionals and consumers to make decisions about deprescribing ChEIs.

Methods A systematic process using the International Patient Decision Aids Standards to develop Patient Decision Aids was employed. Development involved assembling a steering group and defining the CPtDA’s purpose, scope, and target audience. Interviews with consumers and healthcare professionals were conducted to gain feedback on the content, format, structure, comprehensibility, and usability.

Results A steering group composed of healthcare professional and consumer representatives was assembled. The group developed the draft prototype so that it was suitable for further testing. Interviews were conducted with 6 healthcare professionals and 11 consumers. Iterative changes to improve the content, format and structure of the decision aid were made over three rounds of modifications. The main changes included rewording the purpose of the decision aid and simplifying its layout and format. Participants reported that the decision aid is comprehensible and may be useful in clinical practice.

Discussion Limited co-designed resources exist to guide shared decision making about deprescribing decisions for people living with dementia. Our co-designed CPtDA could help people living with dementia and their carers to consider their goals of care and decide to continue or deprescribe their ChEI alongside their healthcare professional.

Conclusion(s) Using the CPtDA in practice will support shared decision making about the continued need of ChEIs. This may lead to increased deprescribing, better aligning medication use with patient goals.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.