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基于对医学生的定性研究探讨减药的角色、责任和动机

: A Discussion of Deprescribing Roles, Responsibilities, and Motivations Based on a Qualitative Study with Healthcare Professional Students.

作者信息

Scott Devin, Hall Amy, Barenie Rachel, Walker Crystal, Khan Muneeza, Koltnow Paul, Callahan William R, Cernasev Alina

机构信息

Department of Interprofessional Education, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA.

Teaching and Learning Center, University of Tennessee Health Science Center, Memphis, TN 38163, USA.

出版信息

Pharmacy (Basel). 2025 May 29;13(3):77. doi: 10.3390/pharmacy13030077.

DOI:10.3390/pharmacy13030077
PMID:40560022
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12196685/
Abstract

UNLABELLED

As the US population ages, the number of prescriptions managed by patients and healthcare teams is increasing. Thus, discontinuing or reducing medications that are considered to pose more risks than benefits can be achieved through deprescribing. Despite increasing calls for a stronger focus on deprescribing in healthcare education, current discussions highlight the lack of training on this topic within healthcare curricula. This is a significant barrier to effectively implementing the deprescribing process. This study aimed to characterize healthcare professional students (HPSs)'s perspectives on deprescribing within an interprofessional healthcare team, particularly regarding the motivations and roles of these future practitioners.

METHODS

Focus groups were conducted with HPSs at the University of Tennessee Health Science Center. The data collection, guided by a conceptual model, took place over three months in 2022. Data analysis was performed using thematic analysis, during which themes were identified through inductive coding.

RESULTS

Participants ( = 36) represented various faculties, including medicine, pharmacy, health professions, nursing, and dentistry. Two themes emerged: (1) Healthcare Team Members' Roles and Responsibilities (2) "": Patient Safety Motivates Deprescribing.

CONCLUSION

Data from HPSs highlighted the importance of an interprofessional healthcare team approach to deprescribing. Based on these insights, educators and practitioners should focus on establishing strong interprofessional healthcare teams that privilege open communication. Teams should consider deprescribing as a patient safety concern, as this may galvanize the team and provide additional motivation for performing the necessary work of deprescribing.

摘要

未标注

随着美国人口老龄化,患者和医疗团队管理的处方数量不断增加。因此,通过减药可以停用或减少那些被认为风险大于益处的药物。尽管越来越多的人呼吁在医学教育中更加重视减药,但目前的讨论凸显了医学课程中缺乏关于这一主题的培训。这是有效实施减药过程的一个重大障碍。本研究旨在描述医疗专业学生(HPSs)在跨专业医疗团队中对减药的看法,特别是关于这些未来从业者的动机和角色。

方法

在田纳西大学健康科学中心对医疗专业学生进行了焦点小组访谈。数据收集以一个概念模型为指导,于2022年进行了三个月。数据分析采用主题分析法,通过归纳编码确定主题。

结果

参与者(n = 36)代表了各个学院,包括医学、药学、健康职业、护理和牙科。出现了两个主题:(1)医疗团队成员的角色和责任(2)“患者安全推动减药”。

结论

医疗专业学生的数据突出了跨专业医疗团队减药方法的重要性。基于这些见解,教育工作者和从业者应专注于建立强大的跨专业医疗团队,重视开放沟通。团队应将减药视为患者安全问题,因为这可能激励团队,并为开展减药所需工作提供额外动力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc0f/12196685/993f06e9f51d/pharmacy-13-00077-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc0f/12196685/993f06e9f51d/pharmacy-13-00077-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc0f/12196685/993f06e9f51d/pharmacy-13-00077-g001.jpg

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本文引用的文献

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Innov Pharm. 2024 Aug 21;15(3). doi: 10.24926/iip.v15i3.5948. eCollection 2024.
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What makes a multidisciplinary medication review and deprescribing intervention for older people work well in primary care? A realist review and synthesis.多学科药物审查和减少老年人用药干预措施在初级保健中为何能良好运行?一项实际审查和综合研究。
BMC Geriatr. 2023 Sep 25;23(1):591. doi: 10.1186/s12877-023-04256-8.
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Student Perspectives on the Pharmacist's Role in Deprescribing Opioids: A Qualitative Study.
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Pharmacy (Basel). 2023 Jul 13;11(4):116. doi: 10.3390/pharmacy11040116.
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Identifying barriers and facilitators to deprescribing benzodiazepines and sedative hypnotics in the hospital setting using the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behaviour (COM-B) Model: a qualitative study.使用理论领域框架和能力、机会、动机和行为(COM-B)模型识别医院环境中减少苯二氮䓬类药物和镇静催眠药使用的障碍和促进因素:一项定性研究。
BMJ Open. 2023 Feb 22;13(2):e066234. doi: 10.1136/bmjopen-2022-066234.
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Professional roles of general practitioners, community pharmacists and specialist providers in collaborative medication deprescribing - a qualitative study.全科医生、社区药剂师和专科医生在协作药物减药方面的专业角色 - 一项定性研究。
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Impact of a pharmacist-administered deprescribing intervention on nursing home residents: a randomized controlled trial.药剂师主导的减药干预对养老院居民的影响:一项随机对照试验。
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