Mrs. Zimmerman: Associate Professor, Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA. Dr. Linsky: Assistant Professor, VA Boston Healthcare System, Department of Medicine, Center for Healthcare Organization and Implementation Research, and Assistant Professor, Boston University School of Medicine, Boston, MA. Dr. Donohoe: Associate Professor, Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA. Dr. Hobgood: Associate Professor, Department of Internal Medicine, Division of Geriatric Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA. Dr. Sargent: Assistant Professor, Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, Richmond, VA. Dr. Salgado: Assistant Professor, Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA.
J Contin Educ Health Prof. 2020 Winter;40(1):49-57. doi: 10.1097/CEH.0000000000000280.
De-prescribing is a complex behavior that benefits from a multifaceted approach to learning. We sought to create and deliver a 1-day interprofessional workshop to enhance de-prescribing knowledge and skills among health care professionals.
Workshop development was based on the Adult Learning Theory and the Theoretical Domains Framework. The workshop addressed provider-related barriers, was created and delivered by an interprofessional team, and combined didactic and active learning techniques. Targeted participants included physicians, advanced practice providers (nurse practitioners and physician's assistants), pharmacists, and clinic staff. Interprofessional workgroups were created a priori. Participants were asked to complete a postprogram evaluation, including whether they would implement changes to practice, teaching, research, or administrative duties after participation.
We created an in-person, 5.5 credit hour, interprofessional de-prescribing workshop that comprised six sessions: (1) polypharmacy and de-prescribing overview; (2) identification of potentially inappropriate medications; (3) prioritization of medications for de-prescribing; (4) design and implementation of a de-prescribing plan; (5) principles for a patient-centered approach; and (6) suggestions for successful collaboration. Forty-one participants attended the workshop, and 38 (92.7%) completed the postprogram assessment. Participants felt they were likely to implement changes in practice, teaching, research, or administrative duties, rating themselves with a mean of 9.2 (SD = 1.06) on a 1 to 10 scale. Ultimately, 96.6% would recommend the workshop to others.
Based on participant feedback, the workshop catalyzed intention to change practice, teaching, research, or administrative duties. Other institutions seeking to change the complex behavior of de-prescribing may wish to model this development and delivery strategy.
撤药是一种复杂的行为,需要采取多方面的方法来学习。我们旨在创建并提供为期一天的跨专业研讨会,以增强医疗保健专业人员的撤药知识和技能。
研讨会的开发基于成人学习理论和理论领域框架。该研讨会解决了与提供者相关的障碍,由跨专业团队创建和提供,并结合了讲座和主动学习技术。目标参与者包括医生、高级执业医师(护士从业者和医师助理)、药剂师和诊所工作人员。预先创建了跨专业工作组。要求参与者完成课程后的评估,包括他们是否会在参与后对实践、教学、研究或行政职责进行更改。
我们创建了一个面对面的、5.5 个学分的跨专业撤药研讨会,由六个部分组成:(1)多药治疗和撤药概述;(2)确定潜在不适当的药物;(3)为撤药确定药物优先级;(4)制定和实施撤药计划;(5)以患者为中心的方法原则;和(6)成功合作的建议。有 41 名参与者参加了研讨会,有 38 名(92.7%)完成了课程后的评估。参与者认为他们很可能会在实践、教学、研究或行政职责方面进行更改,他们在 1 到 10 的范围内给自己的评分平均为 9.2(标准差=1.06)。最终,96.6%的人会向其他人推荐该研讨会。
根据参与者的反馈,该研讨会激发了改变实践、教学、研究或行政职责的意图。其他希望改变撤药这一复杂行为的机构可能希望效仿这种开发和提供策略。