Resumen
Este estudio investigó las barreras y facilitadores para la deprescripción de agonistas de los receptores de benzodiacepina (BZRA) en residencias de ancianos en Bélgica.
Los resultados indican que la deprescripción de BZRA se ve influenciada por la falta de conocimientos y habilidades, la renovación automática de BZRA, las prioridades competitivas, los desafíos sociales, los factores ambientales y la poca participación de los residentes de la residencia de ancianos.
Como fisioterapeuta, es importante estar al tanto de estos factores para poder abogar por la deprescripción segura y efectiva de BZRA en colaboración con otros profesionales de la salud en la residencia de ancianos.
Deprescripción de BZRA en ancianos: un enfoque para fisioterapeutas
Los fisioterapeutas tienen un rol crucial en la deprescripción de BZRA en ancianos. Es esencial para las clínicas de fisioterapia identificar las barreras y facilitadores en geriátricos para mejorar la calidad de vida y seguridad en el tratamiento de sus pacientes.
Abstract original
Barriers and enablers towards benzodiazepine-receptor agonists deprescribing in nursing homes: A qualitative study of stakeholder groups
Background: Despite recommendations to deprescribe chronic benzodiazepine receptor agonists (BZRA) among older adults, the prevalence of their use in Belgian nursing homes (NHs) remains above 50%. The use of a behavioral science approach, starting with the evaluation of barriers and enablers for BZRA deprescribing, has the potential to decrease BZRA prescribing.
Objectives: To identify barriers and enablers for BZRA deprescribing perceived by the different stakeholders involved in nursing home care in Belgium.
Methods: In a purposive sample of 6 NHs, we conducted face-to-face interviews with general practitioners (GPs), and focus groups with other healthcare providers (HCPs), including nurses, pharmacists, occupational therapists, physical therapists, and with NH residents and relatives. All interviews with HCPs were analyzed through deductive thematic analysis, using the theoretical domains framework (TDF) as the coding framework. Residents' and relatives' interviews were analyzed using an inductive thematic approach.
Results: We interviewed 13 GPs, 35 other HCPs, 22 nursing home residents, and 5 relatives. Overall, 9 TDF domains were identified as most relevant among HCPs interviewed: Skills, Beliefs about capabilities, Goals, Memory attention and decision processes, Environmental context and resources, Social influences, Knowledge, Social/professional role and identity, and Beliefs about consequences. Five additional themes emerged from residents' and relatives' interviews: knowledge on medications used, communication with NH staff and GPs, perceived efficacy and necessity of BZRA, influence of the environment, and reluctance towards BZRA deprescribing. Some domains and themes differ between stakeholders (e.g., knowledge), while others match between groups (e.g., environmental aspects).
Conclusion: BZRA deprescribing is influenced by knowledge and skills gaps, automatic BZRA refilling, competing priorities, social challenges, environmental factors and poor nursing home residents involvement. Targeting these barriers will be a key step for implementation of BZRA deprescribing.
| Autores | Perrine Evrard Amber Damiaens Andrea M Patey Jeremy M Grimshaw Anne Spinewine |
| revista | Explor Res Clin Soc Pharm |
| DOI | 10.1016/j.rcsop.2023.100258 |