Barriers and Facilitators to Pharmacist‐Led Deprescribing of Antihypertensives in Long‐Term Care: A Survey‐Based Study
Bibliographic record
Abstract
Pharmacist-led deprescribing is an approach of addressing polypharmacy in the long-term care (LTC) setting. However, the sustainability of this practice has not been widely studied. This study describes facilitators and barriers to pharmacist-led deprescribing from pre- and post-surveys completed as part of a randomized controlled antihypertensive deprescribing trial in Alberta, Canada. The surveys, targeting facilitators and barriers to deprescribing, were developed based on current evidence and designed through an iterative process with pharmacist input and consist of open- and closed-ended questions. Nine pharmacists completed both surveys (seven female; five have been a pharmacist ≥10 years; and eight had their Additional Prescribing Authority [authority to prescribe to full scope of practice]). The key facilitators were (1) pharmacist confidence and attitude toward deprescribing, (2) sufficient patient data, and (3) minimal tools and education required. The key barriers included (1) pharmacist perception of not being the primary decision maker on prescribing decisions, (2) insufficient support from residents' families and physicians, and (3) additional time required. These facilitators and barriers were all identified pre-deprescribing, and confirmed, and more evident post-deprescribing. These barriers will make it challenging for pharmacists to incorporate deprescribing antihypertensives into routine care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".