Preparing the Future of Research on Deprescribing: Results From a Survey of Early Career Researchers at the 2nd International Conference on Deprescribing

Abstract

Deprescribing is an expanding area of research with the term first coined in the scientific literature by Woodward in 2003 [1] and was defined by consensus by Reeve et al. in 2015 [2]. Consequently, the growing community of deprescribing researchers has led to an increasing number of students and a rise in early career researchers (ECRs) in the field.

An ECR is generally defined as someone within the first 5 years of academic or research-related employment following the completion of their postgraduate training, with a focus on stable research development [3]. ECRs often face challenges, including securing funding and research grants, balancing the pressure to publish with clinical, teaching or administrative duties, limited job security, and transitioning from supervised to independent research. They can also face difficulties in establishing collaborations, building a professional network, and gaining recognition in their field [4].

Conferences are an avenue for collaboration, networking and reputation-building in academic communities. The first International Conference on Deprescribing (ICOD) was held in Kolding, Denmark in 2022 followed by ICOD2 in Nantes, France, in 2024. These events brought together global stakeholders, researchers, clinicians and healthcare professionals focused on deprescribing. Our research investigated ECRs' experiences within this community. Our purpose was to characterize the ECRs, the challenges they face, and their insights on the development of a group to support them.

We defined ECR as ‘students or within 5 years of obtaining their PhD or highest degree, not including breaks for part-time work, parental leave, clinical training or health reasons’. Participants of ICOD2 were asked to identify as an ECR when they registered. We distributed an online survey via email on 20 September 2024, with participants having until the start of the conference on 24 September 2024, to submit their responses. Preliminary survey results were presented at an ICOD2 ECR seminar and networking event at the conference.

LimeSurvey (LimeSurvey GmbH, 2023) was used to create the questionnaire. The survey contained 13 questions on demographics, research focus, conference participation, future directions and feedback (Data S1). Future directions included questions on career aspirations, challenges faced and the possible formation of an ECR group. The feedback questions focused on topics of interest at the conference and how the conference could provide support for ECR. The questions were designed by the authors in collaboration with two experts in deprescribing research. The responses were multiple choice, free text or ‘Yes/No’. Responses were anonymous and confidential, and participation was voluntary.

A descriptive analysis was conducted using Excel (Microsoft Corporation, 2021). We defined participants who had a healthcare profession as ‘clinician researchers’. We defined participants who did not declare a healthcare profession as ‘nonclinician researchers’. We compared clinician researchers with nonclinician researchers to identify differences in their research experiences using the Fisher test. A p-value < 0.05 was considered statistically significant. This study received a waiver from the ethics committee of the Canton of Bern, Switzerland.

There was a total of 186 registrants for ICOD2. The survey was sent to 52 (28.0%) registrants who identified as an ECR. We received responses from 47 (90.4%) participants from 14 countries across three continents. Respondent characteristics are shown in Table 1. Six different academic titles were represented, with the most common being PhD student (19, 40.4%). Four healthcare professions were represented: pharmacists (15, 31.9%), medical doctors (8, 17.0%), advanced practice nurses (2, 4.3%) and a nurse (1, 2.1%). We identified 26 (55.3%) clinician researchers and 21 (44.7%) nonclinician researchers. The primary research focus of ECRs were patient outcomes (25, 53.2%), medication safety (23, 48.9%), clinical practice (21, 44.7%) and behavioural science or implementation (19, 40.4%). Older adults were the most targeted population group (31, 66.0%). More than a half of the ECRs were attending ICOD for the first time (25, 53.2%), and most were presenting in some form at the conference (34, 72.3%).

The primary motivations of ECRs for attending the conference were to learn about new research and to network (Table 2). The vast majority of ECRs aspired to pursue a career in academia (38, 80.9%). The main challenges ECRs faced in deprescribing research were time constraints (20, 42.6%), funding (18, 38.3%) and access to data (15, 31.9%).

Both clinician and nonclinician researchers identified challenges in deprescribing research, including funding (42.3% vs. 33.3%, respectively, p = 0.877) and access to data (34.6% vs. 33.3%, respectively, p = 1.000). However, clinician researchers were significantly more likely to report time constraints as a barrier compared with nonclinician researchers (61.5% vs. 28.6%, p = 0.044) (Figure 1).

Over 75% (n = 36) of ECRs were interested in being involved in an ECR deprescribing research group (Table 3). Participants provided free-text responses regarding the purpose of the group, with nine (25.0%) wanting to collaborate and network. Regarding the meeting structures, 11 (30.6%) preferred a journal club format and 10 (27.8%) wanted meetings every 3 to 4 months. At the conference, preliminary survey findings were presented at an ECR seminar and networking event with approximately 20 ECRs in attendance. We had discussions about current funding opportunities for ECRs through the deprescribing networks, we identified shared research interests of the ECRs and encouraged collaborations between individuals, groups and countries.

Our survey received responses from 47 ECRs (90%) from 14 countries who were attending ICOD2. While most ECRs aimed for academic careers, they reported challenges, particularly time constraints for clinician researchers, alongside funding and data access issues. ECRs focused their research on patient outcomes, medication safety, and clinical practice, with older adults as a key population, reflecting some of the global priorities in deprescribing research [5].

Conferences serve as a useful platform for ECRs to build professional networks and to develop their research and interpersonal skills [6]. Effective strategies to support ECR career development and advancement were embedded throughout the ICOD2 conference structure, serving as an example. The Scientific and Organizing Committees deliberately integrated ECRs into key roles, including committee membership (50%), plenary presentations (with ECR speakers in every session), and session chair positions (30%), and ECR-specific presentation awards. The strategy proved successful, with ECRs comprising 72% of presenters and showing strong engagement through a 90% survey response rate. ICOD2's approach demonstrates how conferences can create meaningful advancement opportunities by actively incorporating ECRs into all aspects of scientific programming and leadership. The high interest in forming an international research group for ECRs shows they are seeking networking and ongoing engagement within the field.

Most ECRs aspire to careers in academia (80.9%), which could reflect the need for sustainable academic pathways and long-term support for researchers in the early stage. The key challenges of time constraints, funding and access to data faced by ECRs are common in academia [7, 8], but may be particularly significant in emerging fields like deprescribing. Potential solutions may be mentorship programs or collaborative funding initiatives [9, 10]. Limited funding and data access may ultimately hinder innovation and advancements in deprescribing research. Institutions and funding bodies could better support ECRs by creating targeted grants for pilot funding or travel awards.

Our study had several limitations. The ECRs included in our study were delegates of ICOD2, and we did not survey ECRs outside this conference. It is possible that ECRs attending an international conference may be more supported or have access to greater funding than those unable to attend—meaning we might have underestimated issues faced by ECRs in our survey. However, it was a pragmatic recruitment strategy and the high-level response rate permitted us to draw some conclusions. Also, participants self-reported their ECR status that may have led to a declaration bias. Our survey did not capture how time is allocated across research, clinical, teaching and administrative roles, highlighting the need for future studies to better characterize role distribution among both clinician and nonclinician researchers. A strength was the diverse geographical locations and professional disciplines represented by the participating ECRs.

This survey highlights the experiences of ECRs in deprescribing research, with the conference providing a practical and pragmatic setting for data collection. Future research could incorporate qualitative or mixed methods approaches for deeper insights. Our findings provide a foundation for shaping future ECR surveys, meetings and initiatives both as part of this conference and more broadly.

J.N.S., T.M. and K.R.W. were involved in the conception of the study. J.N.S., T.M. and K.R.W. were involved in the data collection. J.N.S., T.M. and K.R.W. were involved in the data analysis. J.N.S., T.M. and K.R.W. were involved in the data interpretation. J.N.S. and K.R.W. drafted the first version of the manuscript. J.N.S., T.M. and K.R.W. read and approved the final manuscript. J.N.S. can be contacted for access to the dataset underlying the current analysis.

This study received a waiver from the ethics committee of the Canton of Bern, Switzerland.

The authors declare no conflicts of interest.