Evidence map›Paper›PMID 25488097›Full record

SynthesisBMJ open2014

Prescriber barriers and enablers to minimising potentially inappropriate medications in adults: a systematic review and thematic synthesis.

Kristen Anderson, Danielle Stowasser, Christopher Freeman, Ian Scott

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 337 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
337citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

337 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. Screening for potentially inappropriate prescribing in primary care: Canadian guideline.Canadian family physician Medecin de famille canadien · 2026
    Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Trial
  18. Trial
  19. Trial
  20. Trial

277 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kristen AndersonCentre of Research Excellence in Quality & Safety in Integrated Primary-Secondary Care, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia Charming Institute, Camp Hill, Brisbane, Queensland, Australia.ORCID http://orcid.org/0000-0002-1937-2416
Danielle StowasserSchool of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
Christopher FreemanCharming Institute, Camp Hill, Brisbane, Queensland, Australia School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
Ian ScottCentre of Research Excellence in Quality & Safety in Integrated Primary-Secondary Care, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo synthesise qualitative studies that explore prescribers' perceived barriers and enablers to minimising potentially inappropriate medications (PIMs) chronically prescribed in adults.

designA qualitative systematic review was undertaken by searching PubMed, EMBASE, Scopus, PsycINFO, CINAHL and INFORMIT from inception to March 2014, combined with an extensive manual search of reference lists and related citations. A quality checklist was used to assess the transparency of the reporting of included studies and the potential for bias. Thematic synthesis identified common subthemes and descriptive themes across studies from which an analytical construct was developed. Study characteristics were examined to explain differences in findings.

settingAll healthcare settings.

participantsMedical and non-medical prescribers of medicines to adults. OUTCOMES: Prescribers' perspectives on factors which shape their behaviour towards continuing or discontinuing PIMs in adults.

results21 studies were included; most explored primary care physicians' perspectives on managing older, community-based adults. Barriers and enablers to minimising PIMs emerged within four analytical themes: problem awareness; inertia secondary to lower perceived value proposition for ceasing versus continuing PIMs; self-efficacy in regard to personal ability to alter prescribing; and feasibility of altering prescribing in routine care environments given external constraints. The first three themes are intrinsic to the prescriber (eg, beliefs, attitudes, knowledge, skills, behaviour) and the fourth is extrinsic (eg, patient, work setting, health system and cultural factors). The PIMs examined and practice setting influenced the themes reported.

conclusionsA multitude of highly interdependent factors shape prescribers' behaviour towards continuing or discontinuing PIMs. A full understanding of prescriber barriers and enablers to changing prescribing behaviour is critical to the development of targeted interventions aimed at deprescribing PIMs and reducing the risk of iatrogenic harm.

Indexed as

Clinical CompetenceDecision MakingAdultHumansInappropriate PrescribingPatient SafetyGERIATRIC MEDICINEQUALITATIVE RESEARCH

Identifiers

PMID25488097
PMCPMC4265124

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.