Prescribers’ experiences regarding deprescribing of polypharmacy at selected district hospitals in Gauteng province, South Africa

Abstract

Background: Polypharmacy is a significant and persistent issue that hinders patient treatment plans and outcomes. It is associated with a wide range of harmful outcomes, including adverse drug interactions, increased morbidity and even mortality rates. The dire effects of polypharmacy have been associated with increased medication errors, hospitalisations, early readmissions and healthcare costs. Despite the extensive documentation and public awareness of these risks, little has been done to address the problem effectively. Deprescribing serves as a valuable strategy to mitigate and prevent the negative consequences associated with polypharmacy.
Aim: The study sought to explore and describe prescriber’s understanding and experiences regarding deprescribing of polypharmacy.
Settings: The study was conducted at district hospitals in Gauteng province.
Methods: A qualitative, descriptive, exploratory and contextual research approach and design was applied in the research. Non-probability purposive sampling techniques were used to select prescribers. Eight steps of data analysis were followed to analyse the data.
Results: Three themes and nine sub-themes emerged from the study: (1) Negative effects of the impact of polypharmacy (the negative impact on the patients, the impact on prescribers and the impact on the organisation), (2) factors that hinder the deprescribing of polypharmacy (prescriber-related factors, patient-related factors, complexity of the prescribing environment and deficiencies in organisations) and (3) measures that can enhance deprescribing of polypharmacy (holistic systems for the deprescribing of polypharmacy and promotion of awareness and education).
Conclusion: This study concluded that prescribers currently believe deprescribing is a complicated process, and few of them actually engage with it. Deprescribing is a safe and effective way to manage inappropriate polypharmacy. This study recommended that improved interdisciplinary and multidisciplinary approaches among health practitioners be introduced to encourage deprescribing, which will avert polypharmacy in the district hospitals.
Contribution: The research findings provide insight, create awareness and encourage safe, rational and judicious prescribing practices among authorised prescribers in district hospitals in Gauteng province.