ArticleAnnals of family medicine2017
Swimming Against the Tide: Primary Care Physicians' Views on Deprescribing in Everyday Practice.
Article in Annals of family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
78 citing papers in PubMed, 4 syntheses or guidelines pooled it, 168 citations in OpenAlex.
- Deprescribing preventive medications in older adults with advanced frailty, dementia, or limited life expectancy: a systematic review and meta-analysis.BMC geriatrics · 2026Pooled it
- Factors associated with potentially inappropriate prescriptions and barriers to medicines optimisation among older adults in primary care settings: a systematic review.Family medicine and community health · 2021Pooled it
- Generic instruments for drug discontinuation in primary care: A systematic review.British journal of clinical pharmacology · 2020Pooled it
- Health care professionals' attitudes towards deprescribing in older patients with limited life expectancy: A systematic review.British journal of clinical pharmacology · 2019Pooled it
- Ethical Aspects of Physician Decision-Making for Deprescribing Among Older Adults With Dementia.JAMA network open · 2023Trial
- Causal Effects of Early Discontinuation of Proton Pump Inhibitors on Kidney Failure.Kidney international reports · 2026Article
- A consolidated framework for implementation research (CFIR) informed exploration of a primary care intervention to support deprescribing for problematic polypharmacy in older adults living with frailty (DEPPLOY) in England: a qualitative study.International journal of clinical pharmacy · 2026Article
- Stopping antidepressants: when and how.Australian prescriber · 2026Review
- Deprescribing in Older People: A Clinical Practice Guideline Summary.The Medical journal of Australia · 2026Article
- Supporting General Practitioners to Deprescribe Benzodiazepines and Z-Drugs in Primary Care: Findings From a Modified Delphi Study.Basic & clinical pharmacology & toxicology · 2026Article
- A Qualitative Study of Clinician Barriers and Facilitators to De-escalation of Thyroid Stimulating Hormone Suppression in Thyroid Cancer Survivors.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026Article
- A qualitative study on the challenges in deprescribing for elderly patients with polypharmacy.Frontiers in medicine · 2026Article
- Prescribing and deprescribing of atypical antipsychotics in older multimorbid patients.BMC geriatrics · 2025Article
- Facilitators and barriers to the deprescribing of benzodiazepines and Z-drug hypnotics in patients under 65 on adult mental health wards.Scientific reports · 2025Article
- Implementation and acceptability of the Caregiver Care Model in general practice: a mixed-method feasibility study.BMC primary care · 2025Article
- Article
- Physician-reported barriers and facilitators to thyroid hormone deprescribing in older adults.Journal of the American Geriatrics Society · 2025Article
- Engagement of outpatient providers in a deprescribing trial for hospitalized older patients transitioning to post-acute care facilities.Health literacy and communication open · 2025Article
- Article
- "Starting to think that way from the start": approaching deprescribing decision-making for people accessing palliative care - a qualitative exploration of healthcare professionals views.BMC palliative care · 2024Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAvoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing.
methodsWe used a snowball sampling technique to identify potential participants. Physicians were selected on the basis of years in practice, employment status, and practice setting, with an additional focus on information-rich participants. Twenty-four semistructured interviews were audio-recorded, transcribed verbatim, and analyzed to identify emergent themes.
resultsPhysicians described deprescribing as "swimming against the tide" of patient expectations, the medical culture of prescribing, and organizational constraints. They said deprescribing came with inherent risks for both themselves and patients and conveyed a sense of vulnerability in practice. The only incentive to deprescribing they identified was the duty to do what was right for the patient. Physicians recommended organizational changes to support safer prescribing, including targeted funding for annual medicines review, computer prompts, improved information flows between prescribers, improved access to expert advice and user-friendly decision support, increased availability of non-pharmaceutical therapies, and enhanced patient engagement in medicines management.
conclusionsInterventions to support safer prescribing in everyday practice should consider the sociocultural, personal, relational, and organizational constraints on deprescribing. Regulations and policies should be designed to support physicians in practicing according to their professional ethical values.
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What OpenQuestion holds
Registered trials
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.