Getting started with deprescribing in primary care
The ‘Are the medicines working?’ toolkit was designed following an Academic Health Sciences Network North East and North Cumbria funded project exploring barriers to deprescribing in the primary care setting. A summary of the project and its outputs are below.
In 2019, NHS Sunderland Clinical Commissioning Group was awarded project funding to explore barriers to deprescribing in the primary care setting. The project involved three phases. The first phase was a prioritisation exercise with secondary care clinicians to agree what deprescribing messages from validated tools were most important to implement. The second phase took the highest priority deprescribing messages to a workshop with primary care clinicians to explore the potential barriers and facilitators to implementing these messages. The third phase involved developing designs for deprescribing tools to use in primary care. This final phase led to the creation of the ‘Are you medicines working for you?’ deprescribing toolkit.
How might we frame the conversation about deprescribing?
Workshop particicipant, Sunderland
The toolkit was launched with Structured Medication Reviews in Sunderland by Primary Care Network (PCN) Pharmacists in October 2020. The PCN pharmacists incorporated the clinician toolkit into a more comprehensive EMIS Web template as part of their reviews. Due to the COVID-19 pandemic, the patient checklist was often sent as text messages in advance of telephone delivered medication reviews. In January 2021, focus groups with PCN pharmacists were held to get feedback on using the toolkit with patients. Pharmacists found that patients came to medication review appointments more prepared to have conversations about deprescribing and this then facilitated a deeper discussion about medicines.
The toolkit is useful as it gives the medication review structure. You’re able to have more of a deeper conversation with the patient about their medicines.
Primary Care Network Pharmacist, Sunderland
Video overview of the deprescribing toolkit (<5 mins)
The development of the deprescribing toolkit has been shared widely and presented at conferences. You can see a presentation by Gemma Donovan, the project lead below, delivered at the AHSN NENC Polypharmacy Event in November 2020.
Deprescribing in primary care: Getting started (<10 mins)
