Year of publication | Lead author | Country | Aim | Medication types | Participants and setting | Age focus* | Data collection method | Analysis |
---|---|---|---|---|---|---|---|---|
1995 | Britten | England | To identify patients whose current medication is the result of past treatment decisions and is regarded by their current GP as no longer appropriate, and to describe the drugs and the circumstances in which they continue to be prescribed | Miscellaneous PIMs | 7 GPs, primary care | All ages | Descriptive survey; GP selected patients prescribed inappropriate medicines, structured data extraction from notes and GP-facilitated interview of patient | N/A |
1997 | Dybwad | Norway | To understand factors that could result in variations between GPs in order to form hypotheses and build theories about prescribing (main focus on factors that explain higher rates of prescribing) | Benzodiazepines and minor opiates | 38 GPs (18 high rate prescribers, 20 medium to low rate prescribers), primary care | All ages | SSIs (combined with prescription registration information) | Not stated |
1999 | Damestoy | Canada | To explore physicians’ perceptions and attitudes and the decision-making process associated with prescribing psychotropic medications for elderly patients | Psychotropics (sedatives, hypnotics, anxiolytics and antidepressants) | 9 physicians who conduct home visits, primary care | Older patients | (Presumed face-to-face) SSIs | Grounded theory analysis |
2000 | Cantrill | England and Scotland | To explore factors which may contribute to inappropriate long-term prescribing in UK general practice | Miscellaneous PIMs | 22 GPs, primary care | All ages | Face-to-face and telephone interviews informed by specific examples of PIMs identified by validated indicators | Not stated |
2004 | Iliffe | England | To explore beliefs and attitudes about continuing or stopping benzodiazepine hypnotics among older patients using such medicines, and among their GPs | Benzodiazepines | 72 GPs, primary care | Older patients | Non-standardised interview group discussions | Not stated |
2005 | Spinewine | Belgium | To explore the processes leading to inappropriate use of medicines for elderly patients admitted for acute care | Miscellaneous PIMs | 3 geriatricians and 2 house officers, hospital elderly acute care wards | Older patients | SSIs with health professionals triangulated with observation on wards and FGs with elderly inpatients | Not stated |
2005 | Raghunath | England | To understand the prescribing behaviour of GPs by exploring their knowledge, understanding and attitudes towards PPIs | PPIs | 49 GPs, primary care | All ages | Focus groups | Not stated |
2006 | Parr | Australia | To gain a more detailed understanding of GP and benzodiazepine user perceptions relating to starting, continuing and stopping benzodiazepine use | Benzodiazepines | 28 GPs, primary care | All ages | SSIs | Not stated |
2007 | Cook | USA | To understand factors influencing the chronic use of benzodiazepines in older adults | Benzodiazepines | 33 primary care physicians | Older patients | Face-to-face and telephone SSIs | Narrative analysis |
2007 | Rogers | England | To explore the dilemma the controversial benzodiazepine legacy has created for recent practitioners and their view of prescribing benzodiazepines | Benzodiazepines | 22 GPs, primary care | All ages | SSIs | Not stated |
2010 | Anthierens | Belgium | To describe GPs’ views and beliefs on polypharmacy in order to identify the role of the GP in improving prescribing behaviour | Polypharmacy | 65 GPs, primary care | Older patients | Face-to-face individual SSIs (literature informed interview guide) | Content analysis |
2010 | Dickinson | UK | To explore the attitudes of older patients and their GPs to chronic prescribing of antidepressant therapy, and factors influencing such prescribing | Antidepressants | 10 GPs, primary care | Older patients | SSIs | Framework analysis |
2010 | Frich | Norway | To explore GPs’ and tutors’ experiences with peer group academic detailing, and to explore GPs’ reasons for deviating from recommended prescribing practice | Miscellaneous PIMs | 20 GPs (39 GPs also interviewed on topics outside the scope of this review) | Older patients | Focus group interviews following individual receipt of prescription profile report | Thematic content analysis |
2010 | Moen | Sweden | To explore GPs’ perspectives of treating older users of multiple medicines | Polypharmacy | 31 GPs (4 private, 27 county-employed), primary care | Older patients | Focus groups (literature informed question guide) | Conventional content analysis |
2010 | Subelj | Slovenia | To investigate how high-prescribing family physicians explain their own prescription | Benzodiazepines | 10 family physicians (5 high and 5 low prescribers), primary care | All ages | SSIs | Not stated |
2011 | Fried | USA | To explore clinicians’ perspectives of and experiences with therapeutic decision-making for older persons with multiple medical conditions | Polypharmacy | 36 physicians, primary care, vet affairs and academia | Older patients | Focus groups | Content analysis |
2011 | Iden | Norway | To explore decision-making among doctors and nurses on antidepressant treatment in nursing homes | Antidepressants | 16 doctors, 8 each working full-time and part-time in residential aged care facilities | Older patients | Focus groups | Systematic text condensation and analysis |
2012 | Flick | Germany | To explore, given the specific risks and the limited effect of sleeping medication, why doctors prescribe hypnotics for the elderly in long-term care settings | Hypnotics | 20 prescribers servicing residential aged care facilities | Older patients | Episodic interviews | Thematic analysis |
2012 | Schuling | The Netherlands | To explore how experienced GPs feel about deprescribing medication in older patients with multimorbidity and to what extent they involve patients in these decisions | Polypharmacy | 29 GPs, primary care | Older patients | Focus groups | Not stated |
2013 | Clyne | Ireland | To evaluate GP perspectives on a pilot intervention (to reduce PIP in Irish primary care) | Miscellaneous PIMs | 8 GPs in the focus group and 5 GPs for SSIs, primary care | Older patients | Focus group and SSIs | Thematic analysis |
2013 | Wermeling | Germany | To describe factors and motives associated with the inappropriate continuation of prescriptions of PPIs in primary care | PPIs | 10 GPs (5 who frequently continue and 5 who frequently discontinue PPIs), primary care | All ages | SSIs | Framework analysis |
*Age focus refers to the indicative age group of patients who were the focus of participant discussions, as suggested by the terms used in each article, which did not specify the exact age ranges.
GPs, general practitioners; PIMs, potentially inappropriate medications; PIP, potentially inappropriate prescribing; PPIs, proton pump inhibitors; SSIs, semi-structured interviews.