How Are Deprescribing Clinical Practice Guidelines Disseminated and Implemented? A Cross-Sectional Study of International Organisational Stakeholders.

backgroundDeprescribing guidelines support safe medication cessation and complement clinical practice guidelines. However, limited evidence exists on the strategies used by organisations and policy bodies to disseminate and implement such guidelines and their impact. The study aimed to identify dissemination and implementation practices of deprescribing guidelines across international organisations.

methodsAn explanatory mixed-methods design was used, comprising (a) a content-validated 44-item survey comprising components based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and (b) qualitative interviews with survey respondents that provided deeper insights.

resultsOf the 75 unique visitors, 47 respondents from 14 countries provided analysable data (24 completed responses); five participated in a follow-up interview. Whereas 12 out of 27 respondents reported organisational tailoring of guidelines for local context, 18 out of 24 reported a lack of planning for implementation, dissemination and/or evaluation. Nineteen out of 24 respondents reported no monitoring of implementation outcomes. Although only three respondents reported provision of ongoing training and support, 25 out of 32 believed that guideline uptake could be improved. DISCUSSION: Although deprescribing guidelines have gained international attraction, organisations frequently overlook the need for implementation evaluation and the sustainment of implementation. Without attention to these aspects, organisations risk undermining their efforts to implement deprescribing guidelines.