Attitudes of patients, carers and healthcare professionals towards deprescribing in older people receiving palliative care in hospice settings
Deprescribing, Palliative care, Older people, Attitudes, Hospice Settings
Improving the use of medicines is an important element of providing high-quality care for older people and improving their quality of life, especially at the end of life, when older people are often prescribed increasing numbers of medicines. These may include medicines that are unnecessary, and may increase the burden of harm or medicines that are unlikely to achieve a meaningful benefit during the older person’s remaining lifetime. One possible solution to improve medicines use is deprescribing, which has been defined as the planned process of dose reduction or stopping of medication that might be causing harm, or no longer be of benefit, supervised by a healthcare professional.
To date, few studies have investigated the perspectives of health care professionals toward deprescribing in older people in general and in older people with limited life expectancy in particular. Although deprescribing decisions are made by healthcare professionals, the perceptions of people with limited life expectancy and their carers are also considered to be an important factor in guiding this decision-making process. Understanding deprescribing from the perspective of all stakeholders involved is important in helping to determine effective ways to support deprescribing in clinical practice to reduce the negative consequences of potentially inappropriate prescribing in people with life-limiting conditions and limited life expectancy.
This project aims to understand attitudes and beliefs towards deprescribing among older people with life-limiting conditions and people with limited life expectancy, their carers and health and social care professionals, including doctors, nurses and pharmacists, who are involved with hospice care services.
This research will be carried out in three key stages:
1. Administer a survey instrument (online and paper-based) for assessing attitudes and beliefs towards deprescribing;
2. Determine and compare the attitudes and beliefs of older people with life-limiting conditions and people with limited life expectancy, their carers and health and social care professionals;
3. Compare the findings from the survey towards deprescribing in the United Kingdom, with similar data from Australia.
This research is being facilitated with the help of the All Ireland Institute of Hospice and Palliative Care, Marie Curie Hospice, Northern Ireland Hospice, and Sue Ryder Hospice, Cheltenham. We are engaging with these organisations to support older adults and public involvement in this research, data collection, analysis and dissemination.
Data collection is ongoing.
March 2021 – June 2021
Principal Investigator: Dr Carole Parsons, School of Pharmacy, Queen’s University Belfast
Project Team: Ms Tahani Alwidyan, Dr Noleen McCorry, Dr Clare White, Dr Anne Finucane, Dr Tracey McConnell, Dr Gemma Clarke, Dr John MacArtney, Ms Rachel Perry, Dr Paul Perkins.
The study is sponsored by Queen’s University Belfast and funded by the Hashemite University of Jordan, as part of a postgraduate research programme of study.