{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:18:19Z","timestamp":1785525499388,"version":"3.56.0"},"reference-count":59,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>The Drug Burden Index (DBI) measures exposure to anticholinergic and sedative drugs, which are associated with harm in older adults. To facilitate deprescribing in older Australian inpatients, we piloted an intervention bundle integrating the DBI in Electronic Medical Records, clinician deprescribing guides, consumer information leaflets and a stewardship pharmacist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To understand (i) hospital clinician experiences of using the bundle and (ii) consumer (patient and carer) and General Practitioner (GP) experiences of in\u2010hospital deprescribing, following bundle implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Hospital clinicians from target services (General and Geriatric Medicine) at an Australian metropolitan tertiary\u2010referral hospital, were invited to complete surveys, including the System Usability Scale (SUS), and interviews. Patients aged\u2009\u226575 years with high DBI (DBI\u2009\u22651) were admitted to target services, and their carers, received interview invitations. Consenting patients\u2019 GPs received surveys. Qualitative data was thematically analysed. Hospital clinician interviews were mapped to the Human Organisation Technology\u2010fit Framework. Patient interviews were mapped to an adaptation of the National Health Service Patient Experience Framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen hospital clinicians (<jats:italic>n<\/jats:italic>\u2009=\u200915 medical, <jats:italic>n<\/jats:italic>\u2009=\u20092 pharmacists) and four GPs completed surveys. Eight hospital clinicians (<jats:italic>n<\/jats:italic>\u2009=\u20097 medical, <jats:italic>n<\/jats:italic>\u2009=\u20091 pharmacist), seven patients and two carers completed interviews. Hospital clinicians reported good usability (SUS score 71.5\u2009\u00b1\u200912.5). Most themes were around system use and user satisfaction. They reported the intervention was useful for medication review, identified challenges from pre\u2010existing heavy workload and suggested further integration into workflows. Patients and carers reported themes around information, communication and education. Patients reported feeling better or no different post\u2010deprescribing. Patients, carers and GPs described poor communication regarding in\u2010hospital medication changes and their rationale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The intervention was well accepted by hospital clinicians. The bundle requires further integration into workflows for sustainability and assessment of generalisability in other health services. Given patients, carers and GPs reported poor medication\u2010related communication, future interventions may target this.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14220","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T06:45:01Z","timestamp":1732085101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Consumer and multidisciplinary clinician experiences after implementation of the Drug Burden Index intervention bundle to facilitate deprescribing in older inpatients: A mixed method study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7123-9583","authenticated-orcid":false,"given":"Nashwa","family":"Masnoon","sequence":"first","affiliation":[{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and Northern Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarita","family":"Lo","sequence":"additional","affiliation":[{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and Northern Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Baysari","sequence":"additional","affiliation":[{"name":"Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, Charles Perkins Centre The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Bennett","sequence":"additional","affiliation":[{"name":"New South Wales Therapeutic Advisory Group Sydney New South Wales Australia"},{"name":"Sydney Pharmacy School, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Sydney Pharmacy School, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Blyth","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Duong","sequence":"additional","affiliation":[{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and Northern Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah N.","family":"Hilmer","sequence":"additional","affiliation":[{"name":"Kolling Institute, Faculty of Medicine and Health The University of Sydney and Northern Sydney Local Health District Sydney New South Wales Australia"},{"name":"Departments of Clinical Pharmacology and Aged Care Royal North Shore Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0621-2"},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization.Global health and ageing2011. 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