PHARMACISTS’ OPINIONS, PREFERENCES, AND ATTITUDES TOWARDS DEPRESCRIBING: A MIXED-METHODS STUDY

Abstract

Polypharmacy, prevalent especially among older adults, affects approximately 10–20% of the general population and 40–60% of geriatric patients worldwide. Deprescribing, a systematic approach to discontinuing or reducing medications when risks outweigh benefits, involves pharmacists who play a crucial role in medication safety and improving quality of life. This study aimed to provide a valid, comprehensive tool in English to investigate pharmacists' opinions, preferences, and attitudes towards deprescribing, assessing pharmacists' knowledge, awareness, facilitators, and barriers related to deprescribing in Florida. It also qualitatively explores specific barriers and facilitators in various healthcare settings. This study utilized a sequential explanatory mixed-methods approach conducted in three phases: (1) translation, cultural adaptation, and psychometric validation of the CHOPPED questionnaire from Croatian into English, including assessments of internal consistency, test-retest reliability, and construct validity. (2) Quantitative assessment of pharmacists' knowledge, awareness, and perceived barriers and facilitators to deprescribing in Florida using the validated questionnaire. (3) Qualitative exploration through semi-structured interviews to identify and examine deeper insights into deprescribing barriers and facilitators across various healthcare settings. Cronbach’s alpha was 0.884, indicating good internal consistency, and Intraclass correlation coefficient values indicated moderate to excellent reliability. Factor analysis refined CHOPPED into seven factors by merging domains, deleting overlapping items, and transferring items between domains. Pharmacists demonstrated strong knowledge and awareness of deprescribing’s role in improving outcomes and reducing expenditures. Significant barriers included time constraints, unclear guidelines, and low physician acceptance of pharmacists' recommendations, particularly in community pharmacies. Facilitators identified were collaboration with physicians, comprehensive patient information availability, previous successful deprescribing iv experiences, and access to deprescribing-focused education and resources. The observed variations in pharmacists' perceptions of deprescribing, shaped by practice type, professional experience, and educational background, highlight the need for tailored interventions that address the specific challenges and requirements of different practice environments.