Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study

Abstract

ObjectivesThe Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria provide expert consensus guidance about medication use for people with dementia. This study aimed to identify enablers and barriers to implementing the criteria in practice.SettingParticipants came from both rural and metropolitan communities in two Australian states.ParticipantsFocus groups were held with consumers, general practitioners, nurses and pharmacists. Outcomes: data were analysed thematically.ResultsNine focus groups were conducted. Fifty-five participants validated the content of MATCH-D, appraising them as providing patient-centred principles of care. Participants identified potential applications (including the use of MATCH-D as a discussion aid or educational tool for consumers about medicines) and suggested supporting resources.ConclusionParticipants provided insights into applying MATCH-D in practice and suggested resources to be included in an accompanying toolkit. These data provide external validation of MATCH-D and an empiric basis for their translation to practice. Following resource development, we plan to evaluate the feasibility and efficacy of implementation in practice.

Clinicians' Perspectives on Barriers and Enablers of Optimal Prescribing in Patients with Dementia and Coexisting Conditions

“…27 Our findings are also consistent with a focus group study in Australia, in which clinicians expressed concern about stopping medications in patients with dementia and said they would feel more confident if they could provide patients and family caregivers with an educational resource that supported deprescribing "if there was back-up…evidence that [stopping a medication] was the appropriate thing to do." 28 Some clinicians Focus on quality of life I broach it as a positive thing for the patient: "We're not harming them in any way ͓by stopping medicines͔, but we're trying to give them a better quality of life." (cardiologist)…”

Barriers and enablers to deprescribing in people with a life-limiting disease: A systematic review

“…[31][32][33][34][35][36][37][38][39][40][41][42][43] Full-text screening of those 13 records resulted in the exclusion of 8 articles because they did not meet the inclusion criteria. [31][32][33][34][35][36]38,43 The remaining five articles were included in this review. 37,[39][40][41][42] Checking the cited and citing references of the included studies in Web of Science did not lead to any additional studies, nor did the hand search in Drugs & Aging and JAGS.…”

A qualitative exploration of proxy decision makers’ expectations of prescribed medications for people with advanced dementia

“…65,66 Recent work has identified the potential application of the MATCH-D criteria as a discussion aid or educational tool to facilitate this communication. 67 The revised Patients' Attitudes towards Deprescribing (rPATD) questionnaire also shows promise as a tool to supplement and guide communication about stopping medications and to highlight proxy decision maker beliefs and attitudes towards deprescribing. 68 Caregivers find decisions around end-of-life care very difficult.…”