Knowledge and Attitudes of Student Pharmacists Regarding Polypharmacy and Deprescribing: A Cross-Sectional Study

Abstract

Pharmacists play a key role in deprescribing medications. Incorporation of this concept into pharmacy school curricula is important in ensuring that graduates can address the complex needs of an aging population. The aims of this study were to assess if and how student pharmacists were exposed to deprescribing within their curriculum, to assess students’ perceptions regarding their attitudes, ability and confidence in deprescribing, and to assess if reported curricular exposure to this topic resulted in improved perceptions or objective knowledge assessment scores. An electronic survey was distributed to third- and fourth-year pharmacy students at 132 schools of pharmacy. The survey included three sections including: (i) demographics and questions on their exposure to deprescribing and other experiences within their curriculum; (ii) questions regarding their attitudes, ability, and confidence regarding deprescribing on a 5-point Likert-scale; (iii) a knowledge assessment on polypharmacy and deprescribing in the form of 12 multiple-choice questions. Likert-scale questions were analyzed as scales utilizing the mean score for items measuring student perceptions regarding deprescribing attitudes, ability, and confidence. Comparisons were made on each variable between students with and without curricular exposure to deprescribing using t-tests. Ninety-one responses were included in the analysis. Only 59.3% of respondents reported exposure to deprescribing in their didactic coursework. The mean scores on the polypharmacy and deprescribing knowledge assessments were 61.0% and 64.5%, respectively. Those with exposure to deprescribing concepts within their curriculum were more likely to agree that their school’s curriculum prepared them to deprescribe in clinical practice (t(89) = −2.26, p = 0.03). Pharmacy schools should evaluate their curricula and consider the addition of specific deprescribing objectives and outcome measures for didactic and experiential training.

“I Think Deprescribing as a Whole Is a Gap!”: A Qualitative Study of Student Pharmacist Perceptions about Deprescribing

“…While 97.4% of respondents believed that pharmacists played a role in deprescribing, the responses also suggested that more training is required due to a lack of confidence in deprescribing [ 11 ]. Furthermore, a cross-sectional study of student pharmacists from 132 institutions focused on deprescribing in pharmacy curricula exclusively [ 12 ]. The results showed that fewer than half of student pharmacists indicated that deprescribing instruction was part of their non-experiential education or their curriculum prepared them to deprescribe in a clinical setting, while a vast majority reported significant perceived barriers to pharmacist deprescribing [ 12 ].…”

“…Furthermore, a cross-sectional study of student pharmacists from 132 institutions focused on deprescribing in pharmacy curricula exclusively [ 12 ]. The results showed that fewer than half of student pharmacists indicated that deprescribing instruction was part of their non-experiential education or their curriculum prepared them to deprescribe in a clinical setting, while a vast majority reported significant perceived barriers to pharmacist deprescribing [ 12 ]. These studies demonstrate the need for more focused, qualitative inquiry on deprescribing education in the pharmacy curriculum.…”

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

“…[11][12][13][14] Specific to academic pharmacy, there is significant need to enhance teaching of optimal prescribing and deprescribing related content with student assessment measures in the didactic and experiential curricula. 12,15 In addition to educational content and evaluations, there are needs for further research into pharmacists' impact on deprescribing in end-of-life care settings, and to assess the need for and sustainability of palliative and hospice care pharmacists. 1 Within the American Association of Colleges of Pharmacy (AACP) Strategic Plan, academic-practice partnerships that enhance pharmacy education and promote interprofessional practice have been identified for further investigation.…”

“…11 - 14 Specific to academic pharmacy, there is significant need to enhance teaching of optimal prescribing and deprescribing related content with student assessment measures in the didactic and experiential curricula. 12 , 15 In addition to educational content and evaluations, there are needs for further research into pharmacists’ impact on deprescribing in end-of-life care settings, and to assess the need for and sustainability of palliative and hospice care pharmacists. 1 …”

Incorporation of Student Pharmacists into a Proton Pump Inhibitor Deprescribing Telehealth Program for Rural Veterans

“…27,28 Many studies have assessed PPI use and deprescribing protocols but have not focused on the implementation of student-led telehealth interventions. 29,30 Telepharmacy has the potential to provide greater opportunities for patient consultation and adherence monitoring in medically underserved areas, 31 and pharmacy students, in collaboration with pharmacists, are well-positioned to aid in successful deprescribing services utilizing this model of care. This evaluation considers the integration of student pharmacists in collaboration with CPPs to deprescribe PPIs that are being used inappropriately in rural Veterans.…”