Assessment of Knowledge, Attitude and Practice of Primary Health Care Providers towards Deprescribing in Ethiopia

Abstract Background: Deprescribing is a planned and supervised process of reducing, substituting, or discontinuing medicines that are unnecessary or deemed to be harmful that tailored to individual patient needs. The study aimed to assess the knowledge, attitude, and practice of healthcare providers towards deprescribing in Ambo university referral hospital (AURH) and AGH (Ambo general hospital), Ethiopia and identify the perceived barriers and enablers of deprescribing. Methods: A self-administered structured questionnaire was used to collect the information from healthcare providers with facilities based cross-sectional study design from July to September 2021. The data was cleaned, coded, and entered into the SPSS version 25 statistical software for analysis. Descriptive statistics were used to describe the finding.Results: Two hundreds twenty three (223) health care providers in AURH and AGH took part in the study. Among the participants, 155(69.5%) heard about deprescribing but 125(56.1%) reportedly had insufficient knowledge about deprescribing. More than three fourth of respondents (75.8%) agreed that deprescribing does benefits than harms the patients in terms of decreasing pills burden, cost of medication, drug-drug interaction, and improving overall treatment outcomes and quality of life. One hundreds forty-seven (65.9%) of the respondents reported that they had consciously practiced deprescribing. Respondents reported that 149 (66.8%) of them deprescribed antipsychotic which were followed by antidepressant 142(63.7%) and antihypertensive 112(50.2%) medications. Respondents noted that the engagement of pharmacists 83 (37.2%), the existence of evidence based user-friendly guidelines 78(34.9%), having sufficient deprescribing knowledge 57(25.6%) and effective multidisciplinary team collaboration and communication 51 (22.9%) were the most often reported enablers for practicing deprescribing. On the other hand, lack of organizational support 85(38.1%), lack of clear risk-benefit information regarding deprescribing 75(33.6%), time constraint and lack of access to evidence-based guidelines 54(24.2%) were the most frequently reported barriers for practicing barriers.Conclusion: More than half of respondents reported that they had insufficient knowledge about deprescribing. More than three-fourth of the respondents agreed that deprescribing does benefits than harms the patients. In general, the respondents identified interconnected patient-related, provider-related, and system-related barriers to deprescribing. Therefore, multi-level approach through innovations and initiatives should be sought to address the perceived barriers.