Community Pharmacists' Perspectives and Experiences of Deprescribing in Québec, Canada: Findings From a Survey

BACKGROUND: Community pharmacists in Quebec can bill for deprescribing. However, uptake remains low. We aimed to explore how community pharmacists perceive and engage in deprescribing. METHODS: Community pharmacists were invited to complete an online survey through a pharmacists' social media group and a newsletter. Data were analysed using descriptive statistics and univariate chi-square tests. RESULTS: Among 366 respondents, most were women (n = 269; 74%), worked full-time (n = 282; 77%), had time for clinical interventions (n = 223; 61%), while 53% (n = 193) had fewer than 11 years of experience. Three quarters (n = 271) reported initiating deprescribing at least monthly. Side effects (n = 273; 75%) and patients' requests (n = 220; 60%) were more common reasons for deprescribing. More than 70% (n = 268) reported that prescribers usually accepted recommendations. Initial and follow-up consultations were systematically billed by 50% (n = 183) and 48% (n = 174) of respondents, respectively. Deprescribing interventions and billing practices were more common among pharmacists with dedicated clinical time and those working full time (all p < 0.01). Main barriers to billing were insufficient training (n = 217; 59%), uncertainty about reimbursement eligibility (n = 127; 35%) and lack of time (n = 112; 31%). Integrated software was the most common facilitator (n = 246; 67%). CONCLUSION: Deprescribing was commonly reported among respondents and was often prompted by clinical concerns and patient requests. Billing uncertainties and time constraints remained important barriers, highlighting opportunities to better support deprescribing in community pharmacy.