Coordinated_Research_Projects-(ARC)-Fundings
ldri | Bruxelles Woluwe
DI-PRESCRIBE
Deprescribing in older adults through and Implementation science approach – Understanding and addressing what matters at patient/caregiver, health care professionals and organization/environment levels.
Reference number : 22/27-124
Start Date : 01/09/2022
End date : 31/08/2027
Partners
PI (spokeperson) Pr Anne Spinewine, Université catholique de Louvain (UCLouvain), Louvain Drug Research Institute, Clinical pharmacy and pharmacoepidemiology research group (CLIP)
Co-I 1 Pr Jean Macq, Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS)
Co-I 2 Pr Marie de Saint-Hubert, Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS)
Co-I 3 Pr Sandy Tubeuf, Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS)
Co-I 4 Pr Stephan Van den Broucke, Université catholique de Louvain (UCLouvain), Psychological Sciences Research Institute (IPSY)
Co-I 5 Pr Dominique Vanpee, Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS)
Aims of the Coordinated Research Project
Prescription of medications is a fundamental component of health care. However, inappropriate prescribing and medication overuse increase the risk of adverse health outcomes. Deprescribing addresses this issue by reducing or discontinuing medications that are no longer necessary.
The DI-PRESCRIBE project comprises four work packages (WPs):
WP 1 aimed to develop, implement and evaluate two benzodiazepine deprescribing interventions, one in the community setting and one in nursing home setting. The development of these interventions followed recent guidance and proceeded in several phases: 1) developing intervention, 2) assessing the feasibility of the interventions and evaluation design, 3) refining the interventions. Finally, a full evaluation will be performed in a hybrid effectiveness-implementation trial. The research process of these interventions included an economic evaluation aimed at analyzing the costs (i.e., resource use) and consequences (i.e., health outcomes) of the interventions.
WP 2 aims to investigate the determinants of patients’ and informal caregivers’ willingness to engage in deprescription. A systematic review was conducted to identify the main determinants of patients’ and caregivers’ engagement in deprescription. Based on its results, a questionnaire was developed and is currently administered for validation to a sample of patients and caregivers. In addition, a short version of this questionnaire will be developed to facilitate its administration in clinical practice.
WP 3 aims to address knowledge gaps on how to improve future healthcare providers’ competencies (i.e., physicians, nurses and pharmacists) for deprescription. For this purpose, barriers and enablers of deprescription were investigated through questionnaires and interviews. Questionnaires investigated self-reported knowledge, skills and attitudes of students in medicine, pharmacy and nursing. Interviews examined faculty members’ perceptions regarding the current teaching as well as barriers and enablers to teaching deprescribing. These results will be used to design, implement and evaluate an innovative educational approach.
WP 4 aims to explore how national and regional policies can be leveraged to generate real practice change. To this end, a rapid realist review is currently being performed on key policies that aimed to facilitate deprescribing for older people in Belgium, in the three settings of care (i.e., home, nursing home, and hospital). This will inform on mechanisms that could explain why some policies work or not in Belgium. Following the identification of potential mechanisms, these will be discussed with policy makers and evaluated. Such a process will help translate our results into recommendations for both policymakers and stakeholders to increase implementation of deprescribing in clinical practice.
The research team
Anne Spinewine, (PI, Spokeperson)
Professor of clinical pharmacy and leader of the clinical pharmacy research group (CLIP), she has extensive expertise in quantitative and qualitative research on the appropriateness of use of medications in older people, and in interdisciplinary and patient-centered approaches toward optimization of medication use.
Research Group:
People working on the project under other sources of funding: 2 PhD students
People funded by the project: 1 PhD student, 1 post-doc
Jean Macq (CO-I 1)
Professor of public health at the faculty of public health and senior researcher at the Institute of Health and Society (IRSS), he coordinates research and evaluation projects in the field of integrated care, interorganizational network analysis, chronic care and primary care organization. Over the last years, Jean Macq has coordinated national complex evaluations of healthcare reforms.
Marie de Saint-Hubert (CO-I 2)
Geriatrician and professor of geriatric medicine at CHU UCLouvain Namur, she shares her time between clinical functions and research projects focusing on informal caregivers, end-of-life issues and early identification of frail older persons.
Stephan Van den Broucke (CO-I 3)
Professor at the Faculty of Psychology and Educational Sciences, his research focuses on preventive health behaviour change, health promotion, health literacy, chronic disease self-management and public health capacity building. He has been promoter or principal investigator of more than 30 contracted research projects, including several international and European-funded projects.
Research group:
People funded by the project: 1 PhD student
Sandy Tubeuf (CO-I 4)
Professor in health economics, she has led the economic evaluations alongside several landmarks’ clinical trials of complex interventions (e.g. mental health and public health interventions) in the United Kingdom.
Research group:
People working on the project under other sources of funding: 1 research assistant, 1 post-doc
Dominique Vanpee, (CO-I 5)