eprintid: 10166891
rev_number: 7
eprint_status: archive
userid: 699
dir: disk0/10/16/68/91
datestamp: 2023-03-22 11:50:09
lastmod: 2023-03-22 11:50:09
status_changed: 2023-03-22 11:50:09
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Cooper, Ruth E
creators_name: Ashman, Michael
creators_name: Lomani, Jo
creators_name: Moncrieff, Joanna
creators_name: Guy, Anne
creators_name: Davies, James
creators_name: Morant, Nicola
creators_name: Horowitz, Mark
title: "Stabilise-reduce, stabilise-reduce": A survey of the common practices of deprescribing services and recommendations for future services
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D79
divisions: FH7
keywords: Drug addiction, Antidepressants, Drug dependence, Mental health and psychiatry, Clinical psychology, Psychological and psychosocial issues, Mental health therapies, Social psychology
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abstract: BACKGROUND: Public Health England recently called for the establishment of services to help people to safely stop prescribed drugs associated with dependence and withdrawal, including benzodiazepines, z-drugs, antidepressants, gabapentinoids and opioids. NICE identified a lack of knowledge about the best model for such service delivery. Therefore, we performed a global survey of existing deprescribing services to identify common practices and inform service development. METHODS: We identified existing deprescribing services and interviewed key personnel in these services using an interview co-produced with researchers with lived experience of withdrawal. We summarised the common practices of the services and analysed the interviews using a rapid form of qualitative framework analysis. RESULTS: Thirteen deprescribing services were included (8 UK, 5 from other countries). The common practices in the services were: gradual tapering of medications often over more than a year, and reductions made in a broadly hyperbolic manner (smaller reductions as total dose became lower). Reductions were individualised so that withdrawal symptoms remained tolerable, with the patient leading this decision-making in most services. Support and reassurance were provided throughout the process, sometimes by means of telephone support lines. Psychosocial support for the management of underlying conditions (e.g. CBT, counselling) were provided by the service or through referral. Lived experience was often embedded in services through founders, hiring criteria, peer support and sources of information to guide tapering. CONCLUSION: We found many common practices across existing deprescribing services around the world. We suggest that these ingredients are included in commissioning guidance of future services and suggest directions for further research to clarify best practice.
date: 2023-03-15
date_type: published
publisher: Public Library of Science (PLoS)
official_url: https://doi.org/10.1371/journal.pone.0282988
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2011591
doi: 10.1371/journal.pone.0282988
medium: Electronic-eCollection
pii: PONE-D-22-27505
lyricists_name: Horowitz, Mark
lyricists_name: Morant, Nicola
lyricists_id: MAHOR74
lyricists_id: NMORA50
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: PLOS ONE
volume: 18
number: 3
article_number: e0282988
event_location: United States
citation:        Cooper, Ruth E;    Ashman, Michael;    Lomani, Jo;    Moncrieff, Joanna;    Guy, Anne;    Davies, James;    Morant, Nicola;           Cooper, Ruth E;  Ashman, Michael;  Lomani, Jo;  Moncrieff, Joanna;  Guy, Anne;  Davies, James;  Morant, Nicola;  Horowitz, Mark;   - view fewer <#>    (2023)    "Stabilise-reduce, stabilise-reduce": A survey of the common practices of deprescribing services and recommendations for future services.                   PLOS ONE , 18  (3)    , Article e0282988.  10.1371/journal.pone.0282988 <https://doi.org/10.1371/journal.pone.0282988>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10166891/1/journal.pone.0282988.pdf