DO MY PATIENTS NEED ALL THEIR MEDICINES? REGISTERED NURSES’ VIEWS ON DEPRESCRIBING

Registered nurses are key players in caring for older people and are major influencers of prescribing and deprescribing in residential aged care facilities (RACFs). However, studies investigating their opinions about these processes are limited. This study therefore aims to investigate nurses’ views and perceptions on medicines’ use and deprescribing in this setting. A cross-sectional survey was mailed to 307 nurse managers of a nationally representative sample of RACFs. A purpose-developed, pre-tested, 48-item structured questionnaire was used that included both open-ended and close-ended questions. Questions were grouped according to each stage of the medicine use process (prescribing, medicine charts, receiving dispensed medications, administration and monitoring). A dedicated section to explore nurses’ views on deprescribing was included. We received 91 questionnaires in total; yielding a response rate of 29.6%. A descriptive analysis was conducted to analyse close-ended question responses, and a thematic analysis was carried out to analyse open-ended question responses. Nurses highlighted several challenges including achieving medicine reconciliation for new residents, access to physicians to admit patients in a timely fashion, and issues pertaining to lack of clear transcribing of medical information. Most respondents (67.4%) agreed that deprescribing implemented with the help of a clinical pharmacist, would be beneficial and could improve medication adherence (44%), benefit the resident’s quality of life (50.5%) and reduce the length of time spent by nurses on medicines administration (35.2%). This study sheds light on important challenges faced by nurses, regarding medication management. The majority of nurses supported the idea of deprescribing; however a small proportion of them disagreed that it would be beneficial or had no opinion. Increased awareness regarding polypharmacy and potential deprescribing benefits, is necessary to help achieve optimisation of medicine use in older people.