PHARMACISTS’ BEHAVIOR TOWARDS PATIENT CENTERED CARE AND THE NEED FOR DEPRESCRIBING: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/ze43xh31Keywords:
Community Pharmacy, Deprescribing; Medication Review, Patient-Centered Care, Pharmacists, Polypharmacy, Professional PracticeAbstract
Background: Patient-centered care emphasizes collaboration with patients to ensure that healthcare decisions align with their preferences, goals and clinical needs. Within this framework, deprescribing has emerged as an essential strategy to reduce inappropriate medication use, particularly in the context of polypharmacy and aging populations. Community pharmacists are uniquely positioned to support deprescribing through routine medication review and patient engagement. However, evidence regarding their readiness and practical involvement in deprescribing within low- and middle-income countries remains limited. This study addressed this gap by examining community pharmacists’ orientation toward patient-centered care and deprescribing in Pakistan.
Objective: To assess community pharmacists’ attitudes, practices, and readiness toward patient-centered deprescribing and to identify professional factors associated with deprescribing behavior.
Methods: A cross-sectional survey was conducted among community pharmacists in Punjab, Pakistan, between June and August 2025. A previously validated questionnaire was adapted with permission and administered using an electronic survey link and in-person outreach. Pharmacists aged over 20 years, registered with the Pakistan Pharmacy Council, and working in community pharmacies were eligible. Ethical approval was obtained from the Institutional Ethics Committee of Quaid-e-Azam College of Pharmacy, Sahiwal. Descriptive statistics summarized participant characteristics and practice patterns. Binary logistic regression was used to examine associations between pharmacist-related factors and readiness to engage in deprescribing.
Results: A total of 251 pharmacists participated (62.9% male; 37.1% female), with most working in independently owned pharmacies (40.2%). Overall, 75.0% reported receiving training in medication review, and 42.0% considered deprescribing a high priority in routine practice. Pharmacists with medication review training were significantly more likely to engage in deprescribing activities (adjusted OR = 0.249; p < 0.01). Increased exposure to older patients with polypharmacy was also positively associated with deprescribing behavior (adjusted OR = 1.427; p = 0.016). Pharmacist age and gender showed no significant association with deprescribing readiness.
Conclusion: Community pharmacists demonstrated positive attitudes toward patient-centered deprescribing, yet practical implementation remained inconsistent. Strengthening structured training, enhancing interprofessional collaboration, and integrating deprescribing into routine pharmacy practice may improve pharmacists’ contribution to safe and patient-centered medication use.
References
Sepp, K., A. Cavaco, and D. Volmer, The principles of person-centredness in quality patient care-Evaluation of the Community Pharmacy Services Quality Guidelines in Estonia. Int J Health Plann Manage, 2022. 37 Suppl 1(Suppl 1): p. 101-114.
Olson, A.W. and A.L. Burns, From patient centered to person centered: The pharmacist's role and value in community-integrated care transformation. J Am Pharm Assoc (2003), 2023. 63(3): p. 736-741.
Lüthold, R.V., et al., Pharmacists’ attitudes towards interprofessional collaboration to optimise medication use in older patients in Switzerland: a survey study. BMC Health Services Research, 2024. 24(1): p. 849.
Linsky, A.M., et al., Deprescribing To Reduce Medication Harms in Older Adults: Rapid Response, in Making Healthcare Safer IV: A Continuous Updating of Patient Safety Harms and Practices. 2023, Agency for Healthcare Research and Quality (US): Rockville (MD).
Turk, A., et al., Optimising a person-centred approach to stopping medicines in older people with multimorbidity and polypharmacy using the DExTruS framework: a realist review. BMC Medicine, 2022. 20(1): p. 297.
Coe, A., et al., Deprescribing intervention activities mapped to guiding principles for use in general practice: a scoping review. BMJ Open, 2021. 11(9): p. e052547.
Zhou, X., et al., Challenges and barriers to physician decision-making for prescribing and deprescribing among patients with multimorbidity in eastern China’s primary care settings: a qualitative study. BMJ Open, 2025. 15(2): p. e095063.
Robinson, M., S. Mokrzecki, and A.J. Mallett, Attitudes and barriers towards deprescribing in older patients experiencing polypharmacy: a narrative review. NPJ Aging, 2024. 10(1): p. 6.
El-Dahiyat, F., et al., Are pharmacists' knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes. Int J Pharm Pract, 2023. 31(4): p. 387-395.
Endalamaw, A., et al., A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact. BMC Health Services Research, 2024. 24(1): p. 487.
Lukacena, K.M., et al., Patients' attitudes toward deprescribing and their experiences communicating with clinicians and pharmacists. Ther Adv Drug Saf, 2022. 13: p. 20420986221116465.
Okeowo, D.A., et al., Barriers and facilitators of implementing proactive deprescribing within primary care: a systematic review. International Journal of Pharmacy Practice, 2023. 31(2): p. 126-152.
Keij, S.M., et al., Patient-related characteristics considered to affect patient involvement in shared decision making about treatment: A scoping review of the qualitative literature. Patient Educ Couns, 2023. 111: p. 107677.
Kho, B.P., M.W. Chai, and A.Y.Y. Foo, A Qualitative Study Exploring Pharmacists' Perspectives on the Conceptualization and Operationalization of Patient-Centred Care in the Hospital Pharmacy Setting. Malaysian Journal of Pharmacy, 2021. 7(2): p. 13–21.
Faris El-Dahiyat, A.A.J., Sabaa Saleh Al-Hemyari, Moyad Shahwan, Nageeb Hassan, Sumaya Jairoun, Ammar Ali Saleh Jaber, Are pharmacists’ knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes. IJPP, 2023.
Chow, B.J., et al., Education about deprescribing for pre-licensed and licensed healthcare professionals: A scoping review. Br J Clin Pharmacol, 2025. 91(6): p. 1649-1659.
Tobback, E., et al., Implementation of medication review type 2a in community pharmacies: a longitudinal survey study. Front Pharmacol, 2025. 16: p. 1685922.
Alvarez, G., et al., Community pharmacy working conditions: Is stress impacting patient care? Exploratory Research in Clinical and Social Pharmacy, 2025. 20: p. 100641.
Abou, J., et al., Barriers and Enablers of Healthcare Providers to Deprescribe Cardiometabolic Medication in Older Patients: A Focus Group Study. Drugs Aging, 2022. 39(3): p. 209-221.
Hamza, M.A., et al., Medication therapy management in Pakistan: a cross-sectional evaluation of pharmacists' knowledge, attitudes, practices, and barriers. J Pharm Health Care Sci, 2025. 11(1): p. 85.
Hesah AlshammariID, E.A.-S., Zamzam Ahmed, Zoe Aslanpour, Deprescribing attitudes and predictors among older adults attending geriatric clinics in Kuwait. PLOS ONE, 2024.
Hayat, K., et al., Perceptions, Expectations, and Experience of Physicians About Pharmacists and Pharmaceutical Care Services in Pakistan: Findings and Implications. Front Pharmacol, 2021. 12: p. 650137.
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Copyright (c) 2025 Sana Yousaf, Syed Nisar Hussain Shah, Muneeb Ahmad, Aousaf Ahmad, Shakeel Ijaz, Laiba Surosh Tahir, Aiza Ali, Ayesha Saddiqa, Hurain Zafar, Moeeza Malik, Mahnoor Shafiq, Maryam Khalid (Author)
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