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Background <p>Although deprescribing is an evidence-based practice to address polypharmacy in patients with multimorbidity, primary care physicians (PCPs) face multiple challenges in its implementation. Designing implementation strategies to support PCPs in proactively deprescribing is necessary. However, little is known about PCPs’ preferences regarding such strategies. This study aimed to explore the preferences of PCPs in China for implementation strategies that facilitate deprescribing to enhance their acceptability and potential for uptake.</p> Methods <p>A qualitative study was conducted through semi-structured interviews with PCPs from 13 primary healthcare institutions (9 community health centers and 4 township health centers) in Zhejiang and Guangdong Provinces, China, from January 30 to March 15, 2025. Participants were purposively sampled using a maximum variation strategy. Data were analyzed thematically by two independent researchers.</p> Results <p>Twenty PCPs participated in the interviews, with a mean age of 34 years, and 14 (70%) were female. Preferences for implementation strategies centered around three themes: development of training program, provision of prescribing feedback, and prescribing quality assessment and incentives. Training programs were preferred to be practical, clinically relevant, and immediately applicable, with emphasis on case-based learning over theoretical lectures. Participants emphasized the importance of integrated prescribing feedback from credible sources, particularly experienced health professionals familiar with primary care workflows. A multi-level feedback framework was preferred, incorporating both peer feedback from trained colleagues within primary care settings and external quality assessments for objectivity and benchmarking against evidence-based standards.</p> Conclusions <p>Facilitating deprescribing among PCPs caring for patients with multimorbidity and polypharmacy requires integrated implementation strategies focusing on training program, feedback, and assessment and incentives. Future research should develop and pilot test tailored strategies to evaluate their effectiveness, efficiency, and cost.</p>

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Primary care physicians’ preferences for implementation strategies of deprescribing among patients with multimorbidity and polypharmacy in China: a qualitative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月10日

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  • Yu Xia,
  • Leyi Jiang,
  • Ming Yan,
  • Liping Chen,
  • Xinmei Zhou,
  • Lingyan Wu,
  • Yi Guo,
  • Zhijie Xu

摘要

Background

Although deprescribing is an evidence-based practice to address polypharmacy in patients with multimorbidity, primary care physicians (PCPs) face multiple challenges in its implementation. Designing implementation strategies to support PCPs in proactively deprescribing is necessary. However, little is known about PCPs’ preferences regarding such strategies. This study aimed to explore the preferences of PCPs in China for implementation strategies that facilitate deprescribing to enhance their acceptability and potential for uptake.

Methods

A qualitative study was conducted through semi-structured interviews with PCPs from 13 primary healthcare institutions (9 community health centers and 4 township health centers) in Zhejiang and Guangdong Provinces, China, from January 30 to March 15, 2025. Participants were purposively sampled using a maximum variation strategy. Data were analyzed thematically by two independent researchers.

Results

Twenty PCPs participated in the interviews, with a mean age of 34 years, and 14 (70%) were female. Preferences for implementation strategies centered around three themes: development of training program, provision of prescribing feedback, and prescribing quality assessment and incentives. Training programs were preferred to be practical, clinically relevant, and immediately applicable, with emphasis on case-based learning over theoretical lectures. Participants emphasized the importance of integrated prescribing feedback from credible sources, particularly experienced health professionals familiar with primary care workflows. A multi-level feedback framework was preferred, incorporating both peer feedback from trained colleagues within primary care settings and external quality assessments for objectivity and benchmarking against evidence-based standards.

Conclusions

Facilitating deprescribing among PCPs caring for patients with multimorbidity and polypharmacy requires integrated implementation strategies focusing on training program, feedback, and assessment and incentives. Future research should develop and pilot test tailored strategies to evaluate their effectiveness, efficiency, and cost.