Status: This project is in progress

AHRQ community implementation of deprescribing guidelinesPhysicians, pharmacists and nurses work together with patients and families to provide care, but many interventions related to medication optimization are directed at one single profession. Moreover, such interventions rarely engage patients and families.

The overuse of medications can be associated with more harm than benefit. Evidence-based deprescribing guidelines are novel medication optimization tools that provide recommendations regarding appropriateness of tapering or stopping specific medications along with guidance on how to do so safely.

Such deprescribing algorithms and guidelines could be effective in reducing unnecessary or harmful medications if implemented in a community-based setting in partnership with healthcare professionals and patients. Expanded scope of practice for some healthcare professionals may facilitate action, but care must be taken to ensure activities do not occur without engaging other clinicians, patients and their families.

Engaging healthcare providers who care for patients at different sites should facilitate communication and coordinated care and ensure that deprescribing conversations and guidelines are appropriately, effectively and safely implemented.

In this project, researchers and knowledge users will seek to determine the components and processes needed to develop a community-engagement intervention to use and evaluate deprescribing algorithms and guidelines.

The OPEN long-term care pilot-site experience has demonstrated that evidence-based deprescribing guidelines are easily implemented when physicians, pharmacists and nurses work together with patients and their families.

There is untapped potential to achieve change to prescribing practices by engaging the entire community of practice, including the patient, to work together to improve patient outcomes and experiences. Communication and collaboration between hospital and community clinicians, as well as between community pharmacists and primary care physicians or specialists remains challenging and hampers care planning regarding medication monitoring and deprescribing aims.

Community engagement and improved communications have the potential to bring about prescribing change at the community-level and to facilitate communication and collaboration between clinicians and patients.

Research questions

What are the components and processes that need to be generated to develop a community-engagement intervention to use and evaluate deprescribing algorithms and guidelines?

Primary knowledge user: Jessica Hill, Chief Executive Officer, Ontario College of Family Physicians

Project leads: Lisa Dolovich and Barbara Farrell
Research associate: Susan Conklin

For more information about this applied health research question, please contact Annie Lok, AHRQ administrator.