Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2021 Sep;51(9):1473-1478. doi: 10.1111/imj.15208.
Deprescribing, the supervised withdrawal of inappropriate medications, intends to manage polypharmacy, which is prevalent in older patients.
To examine general practitioner (GP) perceptions of communication processes between clinicians in hospital and GP in the community about deprescribing decisions made in hospital.
Focus groups and interviews were held with 15 GP, exploring deprescribing in hospitals, communication of deprescribing information and the format of communications. Sessions were audiotaped, transcribed and analysed using an inductive approach.
GP stated that they should be involved in deprescribing decisions, especially for older complex patients, because of their good knowledge of their patients. Barriers to effective communication included the acute nature of hospital stays and lack of time. Facilitators included long-term relationships of GP with their patients and engaged patients. GP preferred communication of deprescribing decisions to be over the telephone while the patient was still in hospital, and with a concise, electronic discharge summary at the time of discharge. GP indicated that rationale for medication changes and recommended follow-up actions were crucial in a discharge summary to enable care post-discharge.
GP welcome increased communication with hospital clinicians regarding deprescribing decisions made while patients are in hospital. Communication needs to be timely, transparent, succinct and accessible. Lack of time and difficulties contacting hospital clinicians challenge this process.
减药，即监督停止使用不适当的药物，旨在管理老年人普遍存在的多种用药问题。
调查全科医生（GP）对医院临床医生和社区 GP 之间关于在医院做出的减药决定的沟通流程的看法。
采用焦点小组和访谈的方式对 15 名 GP 进行调查，探讨了医院中的减药、减药信息的沟通以及沟通形式。对会议进行录音、转录，并采用归纳法进行分析。
GP 表示，他们应该参与减药决策，特别是对于老年复杂患者，因为他们对患者的了解很好。有效沟通的障碍包括住院时间的急性和缺乏时间。促进因素包括 GP 与患者的长期关系和参与的患者。GP 更喜欢在患者仍在住院期间通过电话进行减药决策沟通，并在出院时提供简洁的电子出院小结。GP 表示，药物变更的理由和推荐的随访行动在出院小结中至关重要，以便在出院后提供护理。
GP 欢迎在患者住院期间与医院临床医生就减药决定进行更多沟通。沟通需要及时、透明、简洁且易于获取。缺乏时间和联系医院临床医生的困难挑战了这一过程。
