{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:49:35Z","timestamp":1787870975166,"version":"build-2784847793"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100000738","name":"US Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Veterans Health Administration"},{"name":"VA Center of Excellence in Substance Addiction Treatment and Education"},{"name":"VA Health Services Research and Development"},{"name":"Quality Enhancement Research Initiative Rapid Response Project","award":["# 12-527"],"award-info":[{"award-number":["# 12-527"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Due to increased risks of overdose fatalities and injuries associated with coprescription of opioids and benzodiazepines, healthcare systems have prioritized deprescribing this combination. Although prior work has examined providers\u2019 perspectives on deprescribing each medication separately, perspectives on deprescribing patients with combined use is unclear. We examined providers\u2019 perspectives on coprescribed opioids and benzodiazepines and identified barriers and facilitators to deprescribing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Qualitative study using semistructured interviews.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>One multisite Veterans Affairs (VA) healthcare system in the United States of America.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>Primary care and mental health prescribers, key clinical leaders, clinical pharmacist specialists (N\u2009=\u200939).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Themes were identified iteratively, through a multidisciplinary team-based process.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Analyses identified four themes related to barriers and facilitators to deprescribing: inertia, prescriber self-efficacy, feasibility of deprescribing\/tapering, and promoting deprescribing, as well as a fifth theme, consequences of deprescribing. Results highlighted the complexity of deprescribing when multiple prescribers are involved, a need for additional support and time, and concerns about patients\u2019 reluctance to discontinue these medications. Facilitators included agreement with the goal of deprescribing and fear of negative consequences if medications are continued. Providers spoke to how deprescribing efforts impaired patient-provider relationships and informed their decisions not to start patients on these medications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although providers agree with the goal, prescribers\u2019 belief in a limited deprescribing role, challenges with coordination among prescribers, concerns about insufficient time and patients\u2019 resistance to discontinuing these medications need to be addressed for efforts to be successful.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa435","type":"journal-article","created":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T20:07:18Z","timestamp":1606075638000},"page":"1559-1569","source":"Crossref","is-referenced-by-count":17,"title":["Primary Care and Mental Health Prescribers, Key Clinical Leaders, and Clinical Pharmacist Specialists\u2019 Perspectives on Opioids and Benzodiazepines"],"prefix":"10.1093","volume":"22","author":[{"given":"Eric J","family":"Hawkins","sequence":"first","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline M","family":"Lott","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa N","family":"Danner","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A","family":"Malte","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildi J","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA"},{"name":"Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Berger","sequence":"additional","affiliation":[{"name":"General Medicine Service, VA Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas M","family":"Donovan","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George G","family":"Sayre","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Department of Health Services, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J","family":"Mariano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA"},{"name":"VA Northwest Veterans Integrated Service Network (VISN 20), VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Saxon","sequence":"additional","affiliation":[{"name":"Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"issue":"43","key":"2021072609400683600_pnaa435-B1","first-page":"1487","article-title":"Vital signs: overdoses of prescription opioid pain relievers\u2014United States, 1999\u20132008","volume":"60","year":"2011","journal-title":"MMWR Morb Mortal Wkly 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