Date

3-2020

Department

School of Nursing

Degree

Doctor of Nursing Practice (DNP)

Chair

Ken Thompson

Keywords

Polypharmacy, Deprescribing, Evidence-based Guidelines, Confidence, Potentially Inappropriate Medications, Clinician

Disciplines

Medicine and Health Sciences | Nursing

Abstract

Polypharmacy is a healthcare problem of epidemic proportions in the United States. It is frequently associated with negative health outcomes in the lives of both elderly and chronically ill persons at excessive costs to the United States healthcare system. Appropriate medication management incorporating evidence-based guidelines is essential to addressing polypharmacy. Prescribing clinicians in all disciplines have expressed a lack of confidence and perceived gaps in knowledge to address polypharmacy through deprescribing. This scholarly project aimed to determine if a polypharmacy protocol intervention, based on the most current evidence-based guidelines in prescribing and deprescribing, would improve clinician confidence in the decision making to reduce polypharmacy and increase ability to recognize potentially inappropriate medications and potentially inappropriate prescribing omissions. The scholarly project utilized a quasi-experimental study design with pre-intervention and post-intervention data collection using the Clinician Polypharmacy Management Survey. Evaluation of the data demonstrated a clinically significant increase in clinician confidence and ability in the recognition of polypharmacy and capability to prescribe and deprescribe following the implementation of the protocol. Although not as strong statistically, all ten areas of confidence measured, demonstrated improvement. The results of the scholarly project agreed with the literature that implementation of evidence-based guidelines for prescribing and deprescribing increases clinician confidence in addressing polypharmacy.

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