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针对未获得执照和已获得执照的医疗保健专业人员的减药教育:一项范围综述。

Education about deprescribing for pre-licensed and licensed healthcare professionals: A scoping review.

作者信息

Chow Brian J, Yuzwenko Alexi M, Dennett Liz, Sadowski Cheryl A

机构信息

Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada.

Rexall Pharmacy, Edmonton, Alberta, Canada.

出版信息

Br J Clin Pharmacol. 2025 Jun;91(6):1649-1659. doi: 10.1002/bcp.70040. Epub 2025 Mar 24.

DOI:10.1002/bcp.70040
PMID:40128588
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12272522/
Abstract

Deprescribing is complex because it involves patients' health, values, and preferences. The World Health Organization and Canadian Medication Appropriateness and Deprescribing Network have recommended that deprescribing be integrated into health curricula, prompting the need for further understanding about deprescribing education. The purpose of this research is to describe the literature regarding deprescribing education provided to healthcare professionals. We conducted a scoping review using the five-step model by Arksey and O'Malley with revisions from Levac et al. The databases searched included Medline, Scopus, Embase and ERIC. Papers were included if they were written in English and contained an educational intervention about deprescribing tailored toward physicians, pharmacists or nurses. White papers and conference abstracts were included. A total of 4853 abstracts were eligible for screening and 46 papers were included (25 full texts, 15 conference abstracts and 6 white papers). Thirty-three papers utilized group education for their intervention and of these, 20 involved interactive portions. Medicine was the most targeted profession, included in 29 papers. The most common outcomes were the number of medications deprescribed and an increase in learner knowledge and self-efficacy regarding deprescribing using self-assessment surveys or post-educational examinations. We found that there is evidence that educational interventions can increase participant knowledge regarding deprescribing and improve self-efficacy. To expand the education of deprescribing, future interventions should engage and utilize a variety of health professions and interventions could include real patients. Further research is required to determine the retention and application of deprescribing knowledge gained from single educational interventions.

摘要

减药是复杂的,因为它涉及患者的健康、价值观和偏好。世界卫生组织和加拿大药物合理性与减药网络建议将减药纳入健康课程,这促使人们需要进一步了解减药教育。本研究的目的是描述有关向医疗保健专业人员提供减药教育的文献。我们使用Arksey和O'Malley的五步模型并结合Levac等人的修订进行了范围综述。检索的数据库包括Medline、Scopus、Embase和ERIC。如果论文是用英文撰写的,并且包含针对医生、药剂师或护士的减药教育干预措施,则纳入研究。白皮书和会议摘要也包括在内。共有4853篇摘要符合筛选条件,纳入了46篇论文(25篇全文、15篇会议摘要和6篇白皮书)。33篇论文在干预中采用了小组教育,其中20篇涉及互动部分。医学是最受关注的专业,有29篇论文涉及。最常见的结果是减药的药物数量以及学习者使用自我评估调查或教育后考试在减药方面的知识和自我效能感的提高。我们发现有证据表明教育干预可以增加参与者关于减药的知识并提高自我效能感。为了扩大减药教育,未来的干预措施应吸引并利用各种卫生专业,干预措施可以包括真实患者。需要进一步研究以确定从单一教育干预中获得的减药知识的保留和应用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e2b/12272522/973325a17bdc/BCP-91-1649-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e2b/12272522/973325a17bdc/BCP-91-1649-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e2b/12272522/973325a17bdc/BCP-91-1649-g001.jpg

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本文引用的文献

1
Education about deprescribing for pre-licensed and licensed healthcare professionals: A scoping review.针对未取得执照和已取得执照的医疗保健专业人员的减药教育:一项范围综述。
Br J Clin Pharmacol. 2025 Jun;91(6):1649-1659. doi: 10.1111/bcp.70040.
2
Global and regional prevalence of polypharmacy and related factors, 1997-2022: An umbrella review.全球和区域范围内的多重用药现状及相关因素,1997-2022 年:伞式综述。
Arch Gerontol Geriatr. 2024 Sep;124:105465. doi: 10.1016/j.archger.2024.105465. Epub 2024 Apr 27.
3
Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide: A Systematic Review and Meta-Analysis.
全球老年人中潜在不适当药物使用的流行情况:系统评价和荟萃分析。
JAMA Netw Open. 2023 Aug 1;6(8):e2326910. doi: 10.1001/jamanetworkopen.2023.26910.
4
The effects of pharmaceutical interventions on potentially inappropriate medications in older patients: a systematic review and meta-analysis.药物干预对老年患者潜在不适当药物的影响:系统评价和荟萃分析。
Front Public Health. 2023 Jul 11;11:1154048. doi: 10.3389/fpubh.2023.1154048. eCollection 2023.
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A Proposed Curricular Framework for an Interprofessional Approach to Deprescribing.一份关于减药的跨专业方法的课程框架提案。
Med Sci Educ. 2023 Feb 23;33(2):551-567. doi: 10.1007/s40670-022-01704-9. eCollection 2023 Apr.
6
Family Conferences to Facilitate Deprescribing in Older Outpatients With Frailty and With Polypharmacy: The COFRAIL Cluster Randomized Trial.家庭会议促进衰弱和多病老年门诊患者的药物减量:COFRAIL 集群随机试验。
JAMA Netw Open. 2023 Mar 1;6(3):e234723. doi: 10.1001/jamanetworkopen.2023.4723.
7
Teaching Deprescribing and Combating Polypharmacy in the Pharmacy Curriculum: Educational Recommendations from Thematic Analysis of Focus Groups.药学课程中减药及应对多重用药的教学:焦点小组主题分析的教育建议
Clin Pract. 2023 Mar 14;13(2):442-453. doi: 10.3390/clinpract13020040.
8
Lessons learned from using whiteboard videos and YouTube for deprescribing guidelines knowledge mobilization.从使用白板视频和 YouTube 进行减药指南知识传播中吸取的教训。
Int J Pharm Pract. 2022 Nov 4;30(5):441-448. doi: 10.1093/ijpp/riac054.
9
Reduction of Potentially Inappropriate Medication in the Elderly.减少老年人潜在不适当用药情况
Dtsch Arztebl Int. 2021 Dec 27;118(51-52):875-882. doi: 10.3238/arztebl.m2021.0372.
10
The Development of a Deprescribing Competency Framework in Geriatric Nursing Education.老年护理教育中减药能力框架的发展
West J Nurs Res. 2021 Jul 22;43(11):1939459211023805. doi: 10.1177/01939459211023805.