# Exploring the need for a clinical decision support system for deprescribing - A qualitative interview study

## TL;DR

This study explores the need for a clinical decision support system to help doctors safely discontinue inappropriate medications, highlighting barriers and requirements for such a tool.

## Contribution

Identifies specific requirements and barriers for deprescribing from physicians' perspectives, supporting the development of a clinical decision support system.

## Key findings

- Swedish physicians face barriers like lack of information on drug tapering.
- Physicians support using a CDSS for deprescribing if it is user-friendly and efficient.
- A CDSS should integrate with electronic health records and provide reliable, summarized information.

## Abstract

Deprescribing (i.e., the process of discontinuing an inappropriate medication) requires time, knowledge, and care, but there is a lack of education, support, and guidelines for this important clinical task. A clinical decision support system (CDSS) aims to influence the quality of care by combining structured medical knowledge with patient-specific information to generate recommendations.

The objective was to examine the need to develop a CDSS for drug deprescribing. Furthermore, this study aimed to examine the obstacles to deprescribing and potential users' requirements for a CDSS for deprescribing.

The qualitative design consisted of semistructured interviews with physicians (n = 10) in Sweden from different disciplines, including geriatrics, primary care and internal medicine. The interviews were conducted using a predefined guide containing multiple questions about any challenges related to deprescribing and the perceived need for a CDSS. A qualitative content analysis was performed to analyse the empirical data.

The interviews provided several aspects of the difficulty of deprescribing medicines. The structure and usability of the CDSS knowledge database in clinical practice needs to be ensured from the outset. Physicians needs fast, simple and up-to-date information filtered, summarized and synthesized from reliable sources. The information should preferably be integrated into pre-existing electronic health record.

There is a need to develop a CDSS for deprescribing. There is little, if any, guidelines or support for deprescribing, which is regarded as a large obstacle. The current findings contribute to further knowledge regarding the perspective of physicians when deprescribing medication.

•Swedish physicians acknowledge several barriers to deprescribing, including the lack of readily available information on when and how to taper drugs.•There is a positive attitude among physicians in Sweden towards using a clinical decision support system for deprescribing.•A clinical decision support system must be user-friendly and not require more time than necessary to obtain relevant and reliable information.

Swedish physicians acknowledge several barriers to deprescribing, including the lack of readily available information on when and how to taper drugs.

There is a positive attitude among physicians in Sweden towards using a clinical decision support system for deprescribing.

A clinical decision support system must be user-friendly and not require more time than necessary to obtain relevant and reliable information.