MediQuit - an electronic deprescribing tool: a pilot study in German primary care; GPs' and patients' perspectives.
Deprescribing
General practice/Family medicine
Health care technology
Multimorbidity
Polypharmacy
Primary Care
Shared decision-making / Patient involvement
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
26 09 2022
26 09 2022
Historique:
received:
01
02
2022
accepted:
01
09
2022
entrez:
26
9
2022
pubmed:
27
9
2022
medline:
28
9
2022
Statut:
epublish
Résumé
General practitioners (GPs) are the central coordinators for patients with multimorbidity and polypharmacy in most health care systems. They are entrusted with the challenging task of deprescribing when inappropriate polypharmacy is present. MediQuit (MQu) is a newly developed electronic tool that guides through a deprescribing consultation. It facilitates the identification of a medicine to be discontinued (stage 1), a shared decision-making process weighing the pros and cons (stage 2), and equips patients with take-home instructions on how to discontinue the drug and monitor its impact (stage 3). We here aim to evaluate utility and acceptance of MQu from GPs' and patients' perspectives. Uncontrolled feasibility study, in which 16 GPs from two regions in Germany were invited to use MQu in consultations with their multimorbid patients. We collected quantitative data on demography, utility and acceptance of MQu and performed descriptive statistical analyses. Ten GPs performed 41 consultations using MQu. Identification (step 1) and implementation elements (Step 3) were perceived most helpful by GPs. Whereas, shared-decision making elements (step 2) revealed room for improvement. Patients appreciated the use of MQu. They were broadly satisfied with the deprescribing consultation (85%) and with their decision made regarding their medication (90%). Implementation of MQu in general practice generally seems possible. Patients welcome consultations targeting medication optimization. GPs were satisfied with the support of MQu and likewise gave important hints for future development.
Sections du résumé
BACKGROUND
General practitioners (GPs) are the central coordinators for patients with multimorbidity and polypharmacy in most health care systems. They are entrusted with the challenging task of deprescribing when inappropriate polypharmacy is present. MediQuit (MQu) is a newly developed electronic tool that guides through a deprescribing consultation. It facilitates the identification of a medicine to be discontinued (stage 1), a shared decision-making process weighing the pros and cons (stage 2), and equips patients with take-home instructions on how to discontinue the drug and monitor its impact (stage 3). We here aim to evaluate utility and acceptance of MQu from GPs' and patients' perspectives.
METHODS
Uncontrolled feasibility study, in which 16 GPs from two regions in Germany were invited to use MQu in consultations with their multimorbid patients. We collected quantitative data on demography, utility and acceptance of MQu and performed descriptive statistical analyses.
RESULTS
Ten GPs performed 41 consultations using MQu. Identification (step 1) and implementation elements (Step 3) were perceived most helpful by GPs. Whereas, shared-decision making elements (step 2) revealed room for improvement. Patients appreciated the use of MQu. They were broadly satisfied with the deprescribing consultation (85%) and with their decision made regarding their medication (90%).
CONCLUSIONS
Implementation of MQu in general practice generally seems possible. Patients welcome consultations targeting medication optimization. GPs were satisfied with the support of MQu and likewise gave important hints for future development.
Identifiants
pubmed: 36162994
doi: 10.1186/s12875-022-01852-2
pii: 10.1186/s12875-022-01852-2
pmc: PMC9511770
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
252Informations de copyright
© 2022. The Author(s).
Références
J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):744-51
pubmed: 17634322
Drugs Aging. 2018 Jan;35(1):61-71
pubmed: 29335932
Ann Fam Med. 2017 Jul;15(4):341-346
pubmed: 28694270
Front Psychol. 2020 Mar 24;11:443
pubmed: 32265780
BMC Fam Pract. 2018 Jul 9;19(1):110
pubmed: 29986668
BJGP Open. 2020 May 1;4(1):
pubmed: 32238392
Drugs Aging. 2021 Aug;38(8):725-733
pubmed: 34251594
J Am Geriatr Soc. 2019 Apr;67(4):674-694
pubmed: 30693946
Br J Clin Pharmacol. 2014 Oct;78(4):738-47
pubmed: 24661192
BMC Fam Pract. 2020 Sep 4;21(1):183
pubmed: 32887551
J Am Geriatr Soc. 2017 Oct;65(10):2265-2271
pubmed: 28804870
PLoS One. 2016 Apr 19;11(4):e0151066
pubmed: 27093289
J Am Geriatr Soc. 2021 Jun;69(6):1508-1518
pubmed: 33598916
Intern Med J. 2015 Mar;45(3):352-6
pubmed: 25735580
BMJ. 2020 Jun 18;369:m1822
pubmed: 32554566
BMJ. 2016 Jun 03;353:i2893
pubmed: 27260319
J Am Geriatr Soc. 2019 Sep;67(9):1843-1850
pubmed: 31250427
Age Ageing. 2015 Mar;44(2):213-8
pubmed: 25324330
Br J Clin Pharmacol. 2020 Jul;86(7):1251-1266
pubmed: 32216066
PLoS One. 2015 Nov 10;10(11):e0142123
pubmed: 26554710
BJGP Open. 2020 Aug 25;4(3):
pubmed: 32723784