Factors related to community pharmacists' intention to provide collaborative deprescribing service for fall-risk medications in older adults: a factorial and theory-based cross-sectional study.

Abstract

Introduction: Collaborative deprescribing of fall-risk-increasing medication by community pharmacists and family physicians can reduce falls in older adults. No such exists in Türkiye.

Aim: To identify factors related to community pharmacists' intention (1) to provide collaborative deprescribing service for fall-risk medications in older adults, and (2) to discuss older adults' potential fall-risk medications with the family physician.

Method: In this cross-sectional study, a web-based survey was conducted between November 2023 and February 2024 among Turkish community pharmacists recruited using convenience sampling. The questionnaire included items at the respondent level (including a theory of planned behaviour-based questionnaire) and the vignette level (including factorial vignettes). The factors related to their intention to perform two behaviours were evaluated: (1) providing collaborative deprescribing service and (2) discussing older adults' potential fall-risk medications with the family physician. Multilevel linear mixed-effects models were used.

Results: Based on responses from 398 community pharmacists (response rate of 93.2%), the intention to provide collaborative deprescribing service was related to their knowledge test score, self-reported rate of older adults served in the community pharmacy (61-80% category), their scores of subjective norm, self-efficacy, and perceived behavioural control (p < 0.05). Community pharmacists' intention to discuss older adults' potential fall-risk medications with the family physician was related to being male, younger age, their experience on patient-centred services, their higher scores of subjective norm, self-efficacy, and perceived behavioural control, and lower scores of attitude (p < 0.05). At vignette level, both intentions were linked to having a history of falls and the number of patients waiting in the community pharmacy (p < 0.05).

Conclusion: A collaborative deprescribing service for fall-risk-increasing medications in older adults could be implemented by addressing key determinants of community pharmacists' intention at both respondent and vignette levels, including subjective norm, self-efficacy, perceived behavioural control, attitude, workload-related factors, and patient clinical history.