Ferreri Stefanie P, Armistead Lori T, Urick Ben, Hughes Tamera D, Hunt Anne-Therese, McBride J Marvin, Niznik Joshua, Roberts Ellen, Sanders Kimberly A, Busby-Whitehead Jan
Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina, 115 Beard Hall, 301 Pharmacy Lane, Chapel Hill, NC 27599-7475, USA.
Hunt Consulting Associates, Chapel Hill, NC, USA.
Explor Res Clin Soc Pharm. 2025 Jun 24;19:100627. doi: 10.1016/j.rcsop.2025.100627. eCollection 2025 Sep.
Opioids and benzodiazepines (BZDs) are among the most prescribed medications that contribute to falls in older adults; however, little guidance exists on their safe prescribing and deprescribing. Although some resources are available to assist providers with opioid and BZD deprescribing, many report lack of confidence as a barrier. The objective of this study was to assess PCPs' confidence in their ability to deprescribe opioids and BZDs before and after an intervention.
We modified a validated deprescribing self-efficacy survey to assess primary care provider (PCP) confidence in deprescribing opioids and BZDs in older adults before and after a consultant pharmacist educational intervention. The survey consisted of 35 questions divided into three sections: deprescribing opioids (10 questions), deprescribing BZDs (10 questions), and deprescribing under potentially impeding circumstances [UPIC] (15 questions). The survey was sent to 88 PCPs using a modified Dillman method. We evaluated providers' confidence on a 100-point scale pre- and post-intervention, comparing the difference-in- differences (DID) in scores between the intervention and control groups.
A total of 41 PCPs (46.6 %) completed the survey both pre-and post-intervention. The intervention group ( = 21) showed an improvement in their knowledge and self-efficacy skills by an average of 19.7 out of 100 points, while the control group ( = 20) improved by an average of 5.2 points. The DID in self-efficacy improvement between the two groups was +14.5 points ( = 0.003) overall. For each of the opioid-, BZD-, and UPIC-specific scores, the intervention group had a statistically significant DID compared to the control group (+15.8, = 0.004; +14.2, = 0.017; +13.9, = 0.016, respectively).
This consultant pharmacist educational intervention improved PCPs' confidence in deprescribing opioids and BZDs in older adults.
阿片类药物和苯二氮䓬类药物（BZDs）是导致老年人跌倒的最常用处方药；然而，关于其安全处方和减药的指导却很少。尽管有一些资源可协助医疗服务提供者进行阿片类药物和BZDs的减药，但许多人报告称缺乏信心是一个障碍。本研究的目的是评估在干预前后，初级保健医生（PCP）对其停用阿片类药物和BZDs能力的信心。
我们修改了一项经过验证的减药自我效能调查问卷，以评估在顾问药师进行教育干预前后，初级保健提供者（PCP）对老年患者停用阿片类药物和BZDs的信心。该调查由35个问题组成，分为三个部分：停用阿片类药物（10个问题）、停用BZDs（10个问题）以及在潜在阻碍情况下停用药物[UPIC]（15个问题）。使用改良的迪尔曼方法将调查问卷发送给88名PCP。我们在干预前后以100分制评估医疗服务提供者的信心，比较干预组和对照组得分的差异中的差异（DID）。
共有41名PCP（46.6%）在干预前后均完成了调查。干预组（n = 21）的知识和自我效能技能平均提高了100分中的19.7分，而对照组（n = 20）平均提高了5.2分。两组之间自我效能提高的DID总体为+14.5分（P = 0.003）。对于阿片类药物、BZDs和UPIC特定得分中的每一项，干预组与对照组相比，DID均具有统计学意义（分别为+15.8，P = 0.004；+14.2，P = 0.017；+13.9，P = 0.016）。
这项顾问药师教育干预提高了PCP对老年患者停用阿片类药物和BZDs的信心。
