Ontario Deprescribing Project Update - February 2014

Ontario Deprescribing Project Update


  • Research Ethics Board approval for Phase II of the study obtained! We are excited to move forward with recruiting three Family Health Teams and three Long-Term Care Homes as guideline pilot sites.
  • The following people have agreed to participate as members on our proton-pump inhibitor (PPI) guideline development team:
    • Dr. Paul Moayyedi, MD, Professor and Director, Division of Gastroenterology, Department of Medicine, McMaster University (Co-lead, clinical expert)
    • Dr. Kevin Pottie, MD, Clinician-Scientist, Bruyère Research Institute; Associate Professor, Department of Family Medicine, University of Ottawa (Co-lead, methods expert)
    • Dr. Carlos Rojas-Fernandez, Pharm.D, Assistant Professor, School of Pharmacy, Schlegel Research Chair in Geriatric Pharmacotherapy, University of Waterloo
    • Dr. Barbara Farrell, Pharm.D., Clinician-Scientist, Bruyère Research Institute; Assistant Professor, Department of Family Medicine, University of Ottawa and School of Pharmacy, University of Waterloo
    • Kate Walsh, B.Sc.Phm., Women's College Hospital, Toronto
  • Over the past two months, two pharmacy residents, Joy Rashid and Taline Boghossian have been working on a systematic review protocol and review to support the PPI deprescribing guideline team. Thanks to Vivian Welch for her mentorship and guidance in registering the title with the Cochrane Collaboration. The systematic review will help the team draft clinical recommendations that will comprise the guideline.
  • Experts have been recruited to review the PPI deprescribing guideline in March with plans for site implementation in April and May 2014.
  • Round 3 of the national Delphi consensus survey to identify top priorities for guideline development is complete! Over 50 physicians, pharmacists, and nurse practitioners have assisted in identifying drug classes with an urgent and clear need for a deprescribing guideline. Stay tuned for more information on the topics chosen for the second and third guidelines!

Spreading the word!

  • In the past month, members of the Deprescribing team have presented on deprescribing for the elderly for students at the University of Waterloo and the University of Toronto and to attendees at the Canadian Society of Hospital Pharmacists Professional Practice Conference.
  • The Deprescribing Team plans to disseminate the unique methods of the Deprescribing project to audiences across Canada this spring with abstract submissions to:
    • The Canadian Pharmacists Association Conference, Saskatoon, SK (June, 2014)
    • The Canadian Evaluation Conference, Ottawa, ON (June, 2014)

Spotlight on Evaluation:

In addition to producing three evidence-based deprescribing guidelines over the course of the project, the team also aims to create an adaptable implementation process for use with many drugs and for implementation in many health care contexts. In order to achieve this, a unique approach to evaluation known as Developmental Evaluation will be used. Developmental Evaluation will involve the collection of various forms of qualitative data from several sources involved in both the guideline development and implementation processes. This method of evaluation will create a feedback loop whereby lessons learned from the development and implementation of the first guideline can be used to help teams improve these processes over time.

The impact the guidelines have on clinical outcomes and areas will also be assessed. One clinical area that will be assessed is that of clinician self-efficacy.  Self-efficacy is the belief in one’s ability to succeed in specific situations. Self-efficacy influences the courses of actions people choose to pursue, the effort they put into something, and how long they will persevere in the face of challenges. A sub-group of the deprescribing team has been developing a self-efficacy survey to assess the impact the guidelines may have on clinician’s perceived self-efficacy to taper or stop medications. The self-efficacy surveys will be completed by clinicians at each participating site just prior to the implementation of the first guideline, and again after the implementation of each guideline. Currently the survey is undergoing assessment for face validity and should be rolled out to site clinicians at the end of March, 2014.

Stay tuned for further updates on the project's evaluation activities!

Meet the new team members!

  • Lisa Pizzola began working at the Bruyère Research Institute in November 2013 after recently graduating in nutrition and health research from Wageningen University in the Netherlands. Lisa is a Research Project Coordinator and is coordinating the team developing the deprescribing guideline for proton pump inhibitors.
  • Wade Thompson is a recent graduate from the School of Pharmacy at the University of Waterloo. He is a Research Project Coordinator at the Bruyère Research Institute and his role on the deprescribing project will be to coordinate the teams that will develop the second and third deprescribing guidelines. In addition to his position at Bruyère, Wade is also a clinical pharmacist at the Arnprior and District Family Health Team. 
A warm welcome to both Lisa and Wade!

Keep in Touch

Follow us on Twitter: @Deprescribing
Contact us:
Check us out online:
Contribute to our Wikipedia page: search ‘deprescribing’ 

To subscribe or unsubscribe to the e-mail list, please e-mail:
Copyright © 2014 Bruyere Research Insitute, All rights reserved.

Graphic Credits:
"Newspaper" designed by John Caserta from The Noun Project; "Announcement" designed by Oliviera Guin from The Noun Project; "Clipboard" designed by Scott Lewis from The Noun Project; "Conversation" designed by Marcio Duarte from The Noun Project