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Title
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Barriers and enablers to deprescribing in people with a life-limiting disease : a systematic review
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Author
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Abstract
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| Background: Knowing the barriers/enablers to deprescribing in people with a life-limiting disease is crucial for the development of successful deprescribing interventions. These barriers/enablers have been studied, but the available evidence has not been summarized in a systematic review. Aim: To identify the barriers/enablers to deprescribing of medications in people with a life-limiting disease. Design: Systematic review, registered in PROSPERO (CRD42017073693). Data sources: A systematic search of MEDLINE, Embase, Web of Science and CENTRAL was conducted and extended with a hand search. Peer-reviewed, primary studies reporting on barriers/enablers to deprescribing in the context of explicit life-limiting disease were included in this review. Results: A total of 1026 references were checked. Five studies met the criteria and were included in this review. Three types of barriers/enablers were found: organizational, professional and patient (family)-related barriers/enablers. The most prominent enablers were organizational support (e.g. for standardized medication review), involvement of multidisciplinary teams in medication review and the perception of the importance of coming to a joint decision regarding deprescribing, which highlighted the need for interdisciplinary collaboration and involving the patient and his family in the decision-making process. The most important barriers were shortages in staff and the perceived difficulty or resistance of the nursing home residents family or the resident himself. Conclusion and implications of key findings: The scarcity of findings in the literature highlights the importance of filling this gap. Further research should focus on deepening the knowledge on these barriers/enablers in order to develop sustainable multifaceted deprescribing interventions in palliative care. |
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Language
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English
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Source (journal)
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Palliative medicine. - London
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Publication
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London
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Sage publications ltd
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2019
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ISSN
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0269-2163
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DOI
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10.1177/0269216318801124
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Volume/pages
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33
:1
(2019)
, p. 37-48
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ISI
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000453592400004
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Pubmed ID
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30229704
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Full text (Publisher's DOI)
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Full text (open access)
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