Zimmerman Kristin M, Bell Courtney A, Donohoe Krista L, Salgado Teresa M
Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA.
School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA.
Gerontol Geriatr Educ. 2020 Jan-Mar;41(1):63-84. doi: 10.1080/02701960.2019.1661840. Epub 2019 Sep 5.
With increasing rates of polypharmacy among older adults, preparedness of current and future health care professionals to identify and deprescribe potentially inappropriate medications (PIMs) is critical. Medicine (n = 28), pharmacy (n = 35) and nursing (n = 11) trainees enrolled in an interprofessional course completed a survey assessing preparedness, confidence and attitudes toward deprescribing, and perception of interprofessional roles in the process. Pharmacy ( = .001) and nursing ( = .007) felt that their curriculum prepared them better to identify and deprescribe PIMs compared to medicine trainees. Pharmacy trainees perceived significantly more barriers to deprescribing compared to medicine ( = .003), but not nursing trainees. Physicians and pharmacists were perceived as the main drivers of the deprescribing process. Current curricular content should be modified to address lack of preparedness to deprescribe in clinical practice. Addressing such gaps as part of an interprofessional team may increase interprofessional role recognition and translate into changes in clinical practice as trainees move into the workforce.
随着老年人多重用药率的不断上升,当前及未来的医护专业人员识别并减少开具潜在不适当药物(PIMs)的能力至关重要。参加跨专业课程的医学(n = 28)、药学(n = 35)和护理(n = 11)专业学员完成了一项调查,评估他们在减少开具药物方面的准备情况、信心和态度,以及对跨专业角色在这一过程中的认知。与医学专业学员相比,药学专业学员(P = 0.001)和护理专业学员(P = 0.007)认为他们的课程让他们在识别和减少开具PIMs方面准备得更好。与医学专业学员相比,药学专业学员认为在减少开具药物方面存在更多显著障碍(P = 0.003),但护理专业学员并非如此。医生和药剂师被视为减少开具药物过程的主要推动者。应修改当前的课程内容,以解决临床实践中减少开具药物准备不足的问题。作为跨专业团队的一部分解决此类差距,可能会提高跨专业角色认知,并随着学员进入工作岗位转化为临床实践的改变。