School of Health Sciences, University of York, York, UK.
School of Pharmacy and Medical Sciences University of Bradford, Bradford, UK.
Int J Pharm Pract. 2023 May 7;31(3):282-289. doi: 10.1093/ijpp/riad016.
(1) Present deprescribing experiences of patients living with frailty, their informal carers and healthcare professionals; (2) interpret whether their experiences are reflective of person-centred/collaborative care; (3) complement our findings with existing evidence to present a model for person-centred deprescribing for patients living with frailty, based on a previous collaborative care model.
Qualitative design in English primary care (general practice). Semi-structured interviews were undertaken immediately post-deprescribing and 5/6 weeks later with nine patients aged 65+ living with frailty and three informal carers of patients living with frailty. Fourteen primary care professionals with experience in deprescribing were also interviewed. In total, 38 interviews were conducted. A two-staged approach to data analysis was undertaken.
Three themes were developed: attitudes, beliefs and understanding of medicines management and responsibility; attributes of a collaborative, person-centred deprescribing consultation; organisational factors to support person-centred deprescribing. Based on these findings and complementary to existing evidence, we offer a model for person-centred deprescribing for patients living with frailty.
Previous models of deprescribing for patients living with frailty while, of value, do not consider the contextual factors that govern the implementation and success of models in practice. In this paper, we propose a novel person-centred model for deprescribing for people living with frailty, based on our own empirical findings, and the wider evidence base.
(1) 介绍患有衰弱症的患者、他们的非正式照顾者和医疗保健专业人员的减药经验；(2) 解释这些经验是否反映了以患者为中心/协作式护理；(3) 用现有证据补充我们的发现，根据之前的协作式护理模式，为患有衰弱症的患者提出以患者为中心的减药模型。
在英国初级保健（全科医疗）中采用定性设计。在减药后立即和 5/6 周后，对 9 名年龄在 65 岁以上患有衰弱症的患者和 3 名患有衰弱症患者的非正式照顾者进行了半结构化访谈。还对 14 名有减药经验的初级保健专业人员进行了访谈。总共进行了 38 次访谈。采用两阶段数据分析方法。
制定了三个主题：对药物管理和责任的态度、信念和理解；协作式、以患者为中心的减药咨询的属性；支持以患者为中心的减药的组织因素。基于这些发现和对现有证据的补充，我们为患有衰弱症的患者提供了以患者为中心的减药模型。
以前针对患有衰弱症的患者的减药模型虽然有价值，但没有考虑到影响模型在实践中实施和成功的背景因素。在本文中，我们根据自己的实证发现和更广泛的证据基础，为患有衰弱症的人提出了一种新颖的以患者为中心的减药模型。
