Pharmacist-independent prescriber deprescribing in UK care homes: Contextual factors associated with increased activity

Mohammed Alharthi; Sion Scott; David Phillip Alldred; Richard Holland; Carmel Hughes; Linda Birt; Jeanette Blacklock; Christine Bond; Allan Clark; David Wright

doi:10.1111/bcp.15643

Pharmacist-independent prescriber deprescribing in UK care homes: Contextual factors associated with increased activity

Mohammed Alharthi, Sion Scott^* (Corresponding Author), David Phillip Alldred, Richard Holland, Carmel Hughes, Linda Birt, Jeanette Blacklock, Christine Bond, Allan Clark, David Wright

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Aims The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years? experience as a pharmacist and as a prescriber). Results Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature.

Original language	English
Pages (from-to)	1509-1513
Number of pages	5
Journal	British Journal of Clinical Pharmacology
Volume	89
Issue number	4
Early online date	23 Dec 2022
DOIs	https://doi.org/10.1111/bcp.15643
Publication status	Published - 1 Apr 2023

Bibliographical note

ACKNOWLEDGEMENTS
We would like to thank the residents, families, pharmacists, medical practice staff and care home staff who contributed to CHIPPS.

Funding information: This study is funded by the National Institute for Health Research (NIHR) for Health Research (NIHR) Translating Research into Policy funding scheme (Award ID: NIHR202053). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Data Availability Statement

DATA AVAILABILITY STATEMENT
The analysed datasets used in the current study are available upon reasonable request from the corresponding author

Keywords

deprescription
long-term care facilities
medication review
medicines optimization
nursing home
polypharmacy
residential home

Access to Document

10.1111/bcp.15643Licence: CC BY

Alharthi_etal_BJCP_Pharmacist_Independent_Prescriber_VoR
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2022 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society https://creativecommons.org/licenses/by/4.0/
Final published version, 1.19 MBLicence: CC BY

Cite this

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title = "Pharmacist-independent prescriber deprescribing in UK care homes: Contextual factors associated with increased activity",

abstract = "Aims The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years? experience as a pharmacist and as a prescriber). Results Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature.",

keywords = "deprescription, long-term care facilities, medication review, medicines optimization, nursing home, polypharmacy, residential home",

author = "Mohammed Alharthi and Sion Scott and Alldred, {David Phillip} and Richard Holland and Carmel Hughes and Linda Birt and Jeanette Blacklock and Christine Bond and Allan Clark and David Wright",

note = "ACKNOWLEDGEMENTS We would like to thank the residents, families, pharmacists, medical practice staff and care home staff who contributed to CHIPPS. Funding information: This study is funded by the National Institute for Health Research (NIHR) for Health Research (NIHR) Translating Research into Policy funding scheme (Award ID: NIHR202053). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.",

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AU - Alharthi, Mohammed

AU - Scott, Sion

AU - Alldred, David Phillip

AU - Holland, Richard

AU - Hughes, Carmel

AU - Birt, Linda

AU - Blacklock, Jeanette

AU - Bond, Christine

AU - Clark, Allan

AU - Wright, David

N1 - ACKNOWLEDGEMENTS We would like to thank the residents, families, pharmacists, medical practice staff and care home staff who contributed to CHIPPS. Funding information: This study is funded by the National Institute for Health Research (NIHR) for Health Research (NIHR) Translating Research into Policy funding scheme (Award ID: NIHR202053). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

PY - 2023/4/1

Y1 - 2023/4/1

N2 - Aims The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years? experience as a pharmacist and as a prescriber). Results Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature.

AB - Aims The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years? experience as a pharmacist and as a prescriber). Results Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature.

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KW - long-term care facilities

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KW - medicines optimization

KW - nursing home

KW - polypharmacy

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DO - 10.1111/bcp.15643

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ER -

Pharmacist-independent prescriber deprescribing in UK care homes: Contextual factors associated with increased activity

Abstract

Bibliographical note

Data Availability Statement

Keywords

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