Deprescribing is an effective strategy to manage polypharmacy and improve patient outcomes. The notion of a potential role for pharmacists in a multidisciplinary team approach to deprescribing has been identified in quantitative and qualitative literature. However, stakeholders' perceptions of this role, and factors that may impede or facilitate the pharmacist's involvement have not been elucidated. The application in ambulatory care also requires clarification. Understanding stakeholders' views is essential to optimise involvement of the pharmacist in deprescribing and improve practice. First, to synthesize the perspectives and experiences of stakeholders (primary care providers, pharmacists, patients, and carers) regarding the role and involvement of the pharmacist in deprescribing in ambulatory care settings. Second, to identify barriers and strategies to enhancing pharmacist involvement in deprescribing. A systematic search was conducted across CINAHL, Embase, Medline, and Scopus from database inception to April 2023 for qualitative studies in English exploring the pharmacist's role in deprescribing. Data were extracted for iterative and inductive development of themes. A meta-synthesis facilitated the identification of overarching themes. Qualitative secondary analysis enabled identification of barriers and facilitators to the pharmacist's involvement in deprescribing. From 285 articles identified, 9 studies were included which explored the views of general practitioners, specialist physicians, pharmacists, nurse practitioners, patients, carers, and general practice and clinic staff as stakeholders in deprescribing in ambulatory care. The meta-synthesis identified 4 over-arching themes: (1) therapeutic impetus and the status quo mentality, (2) role and responsibility, (3) multidisciplinary care, and (4) conflicting interests in pharmacy practice. Strategies to enhance pharmacists' involvement in deprescribing emerged from the data, and the pharmacist's role was strongly encouraged by stakeholders despite logistical and perceptual barriers identified. Incorporation of the strategies to enhance the pharmacist's involvement in deprescribing identified in this review is encouraged to optimise patient-centred care and improve practice.

中文翻译：

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利益相关者对药剂师在门诊护理中取消处方作用的看法和经验：定性综合综合


取消处方是管理多药治疗和改善患者治疗效果的有效策略。定量和定性文献中已经确定了药剂师在多学科团队取消处方方法中的潜在作用的概念。然而，利益相关者对此角色的看法以及可能阻碍或促进药剂师参与的因素尚未阐明。在门诊护理中的应用也需要澄清。了解利益相关者的观点对于优化药剂师在取消处方和改进实践中的参与至关重要。首先，综合利益相关者（初级保健提供者、药剂师、患者和护理人员）关于药剂师在门诊护理环境中取消处方的作用和参与的观点和经验。其次，确定加强药剂师参与取消处方的障碍和策略。从数据库建立到 2023 年 4 月，我们在 CINAHL、Embase、Medline 和 Scopus 上进行了系统性检索，以英语进行定性研究，探讨药剂师在取消处方方面的作用。提取数据用于主题的迭代和归纳开发。综合综合有助于确定总体主题。定性二次分析能够识别药剂师参与取消处方的障碍和促进因素。从确定的 285 篇文章中，纳入了 9 项研究，探讨了全科医生、专科医生、药剂师、执业护士、患者、护理人员以及全科医生和诊所工作人员作为利益相关者在门诊护理中取消处方的观点。 综合综合确定了 4 个总体主题：(1) 治疗动力和现状心态，(2) 角色和责任，(3) 多学科护理，(4) 药学实践中的利益冲突。数据中出现了加强药剂师参与取消处方的策略，尽管存在后勤和感知障碍，但利益相关者强烈鼓励药剂师的作用。鼓励纳入本次审查中确定的加强药剂师参与取消处方的策略，以优化以患者为中心的护理并改进实践。