Abstract：
Conduct a systematic review to investigate current beliefs, practices, perceptions, and motivations towards deprescribing practices from the healthcare professional perspective in older adults residing in long term care facilities with cardiometabolic conditions, using a narrative approach.
Studies were identified using a literature search of MEDLINE, CINAHL and Web of Science from inception to June 2023 Two reviewers (EH and AA) independently extracted data from each selected study using a standardised self-developed data extraction proforma. Studies reviewed included cross-sectional and observational studies. Data was extracted on baseline characteristics, motivations and beliefs and was discussed using a narrative approach.
Eight studies were identified for inclusion. Deprescribing approaches included complete withdrawal, dose reduction, or switching to an alternative medication, for at least one preventive medication. Most healthcare professionals were willing to initiate deprescribing strategies and stated the importance of such interventions, however many felt inexperienced and lacked the required knowledge to feel comfortable doing so.
Deprescribing is a key strategy when managing older people with cardiometabolic and multiple long term conditions (MLTC). Overall, HCPs including specialists, were happy to explore deprescribing strategies if provided with the relevant training and development to do so. Barriers that still exist include communication and consultation skills, a lack of evidence-based guidance and trust based policies, and a lack of MDT communications and involvement.
PROSPERO CRD42022335106.
Studies were identified using a literature search of MEDLINE, CINAHL and Web of Science from inception to June 2023 Two reviewers (EH and AA) independently extracted data from each selected study using a standardised self-developed data extraction proforma. Studies reviewed included cross-sectional and observational studies. Data was extracted on baseline characteristics, motivations and beliefs and was discussed using a narrative approach.
Eight studies were identified for inclusion. Deprescribing approaches included complete withdrawal, dose reduction, or switching to an alternative medication, for at least one preventive medication. Most healthcare professionals were willing to initiate deprescribing strategies and stated the importance of such interventions, however many felt inexperienced and lacked the required knowledge to feel comfortable doing so.
Deprescribing is a key strategy when managing older people with cardiometabolic and multiple long term conditions (MLTC). Overall, HCPs including specialists, were happy to explore deprescribing strategies if provided with the relevant training and development to do so. Barriers that still exist include communication and consultation skills, a lack of evidence-based guidance and trust based policies, and a lack of MDT communications and involvement.
PROSPERO CRD42022335106.
摘要：
目的：进行系统评价以调查当前的信念，实践,感知，以及从医疗保健专业角度来看，居住在患有心脏代谢疾病的长期护理设施中的老年人的非处方做法的动机，使用叙事方法。
方法：使用MEDLINE的文献检索来确定研究，CINAHL和WebofScience从成立到2023年6月，两名审稿人（EH和AA）使用标准化的自行开发的数据提取形式独立地从每项选定的研究中提取数据。审查的研究包括横断面研究和观察性研究。根据基线特征提取数据，动机和信念，并使用叙事方法进行了讨论。
结果：确定纳入8项研究。无效的方法包括完全退出，剂量减少,或者改用替代药物，至少一种预防性药物。大多数医疗保健专业人员都愿意启动取消处方策略，并指出此类干预措施的重要性。然而，许多人感到缺乏经验，缺乏所需的知识，让他们感到舒服。
结论：治疗患有心血管代谢疾病和多种长期疾病（MLTC）的老年人时，去处方是一项关键策略。总的来说,包括专家在内的HCP，如果提供相关的培训和发展，我们很乐意探索取消处方的策略。仍然存在的障碍包括沟通和咨询技巧，缺乏基于证据的指导和基于信任的政策，缺乏MDT沟通和参与。
背景：PROSPEROCRD4202235106。
方法：使用MEDLINE的文献检索来确定研究，CINAHL和WebofScience从成立到2023年6月，两名审稿人（EH和AA）使用标准化的自行开发的数据提取形式独立地从每项选定的研究中提取数据。审查的研究包括横断面研究和观察性研究。根据基线特征提取数据，动机和信念，并使用叙事方法进行了讨论。
结果：确定纳入8项研究。无效的方法包括完全退出，剂量减少,或者改用替代药物，至少一种预防性药物。大多数医疗保健专业人员都愿意启动取消处方策略，并指出此类干预措施的重要性。然而，许多人感到缺乏经验，缺乏所需的知识，让他们感到舒服。
结论：治疗患有心血管代谢疾病和多种长期疾病（MLTC）的老年人时，去处方是一项关键策略。总的来说,包括专家在内的HCP，如果提供相关的培训和发展，我们很乐意探索取消处方的策略。仍然存在的障碍包括沟通和咨询技巧，缺乏基于证据的指导和基于信任的政策，缺乏MDT沟通和参与。
背景：PROSPEROCRD4202235106。
