Deprescribing in primary care runs counter to medical culture

Although deprescribing (tapering and withdrawing medicines when risks outweigh potential benefits) is essential to best prescribing practices, it runs counter to patient expectations, medical culture, and organizational factors. In a qualitative study of 24 primary care physicians in Auckland, New Zealand, participants recognized the importance of deprescribing for older patients, while identifying many barriers and few incentives to the practice. Less experienced physicians and those in short-term low-trust therapeutic relationships reported finding deprescribing challenging. The authors state that interventions to support safer prescribing should consider sociocultural influences, the importance to physicians of maintaining relationships, the sense of vulnerability many physicians feel in practice, and the organizational constraints they face.

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http://www.annfammed.org/content/15/4/341

Swimming Against the Tide: Primary Care Physicians' Views on Deprescribing in
Everyday Practice
Katharine A. Wallis, MBChB, PhD, MBHL, FRNZCGP, et al, University of Auckland, Auckland, New Zealand