Evaluation of a Pharmacist-Led Intervention Focused on the Deprescribing of Cardiovascular and Antidiabetic Medication in Older Patients With Polypharmacy: Patients' and Pharmacists' Experiences

BACKGROUND: In the Netherlands, community pharmacists (CPs) are required to conduct annual clinical medication reviews (CMRs) for older patients with polypharmacy. In practice, these reviews are insufficiently implemented, and opportunities to deprescribe inappropriate cardiovascular and antidiabetic medications are often missed. The LeMON study focused on deprescribing, enhancing CPs' awareness and ability to reduce unnecessary medication through close collaboration with general practitioners (GPs). AIM: The aim of the study was to evaluate the experiences of patients and CPs who participated in the LeMON study. METHODS: Patient experiences and satisfaction were assessed using the Patient-Reported Experience Measure (PREM) and the Treatment Satisfaction Questionnaire for Medication (TSQM). Semistructured interviews with CPs were analysed using the extended normalization process theory (eNPT), covering potential, capability, capacity and contribution. RESULTS: Of 140 patients, 62 (44%) completed the questionnaires. Patients reported high satisfaction, felt their medication concerns were addressed andappreciated CP recommendations. TSQM scores were moderate to high across effectiveness, side effects, convenience andoverall satisfaction. CPs valued the online training and acknowledged the importance of deprescribing. Challenges included addressing patient concerns in the absence of symptoms and deprescribing medications initially prescribed by specialists, which could reduce CPs' confidence and patient trust. CONCLUSION: Patient and CP experiences highlight the need for specific knowledge and training, shared clinical data andclose CP-GP collaboration to implement deprescribing-focused CMRs routinely. Addressing patient concerns and deprescribing specialist-initiated medications requires effective communication skills and structured local or regional protocols for multidisciplinary collaboration between primary and secondary care.