(3) A curriculum framework for an interprofessional approach to deprescribing

Objective : Health care providers acknowledge that they lack knowledge and skills to feel confident in deprescribing. Although published educational frameworks are available for prescribing, there are no similar frameworks for deprescribing. Our objective was to design an interprofessional curriculum framework for deprescribing that could be implemented into undergraduate medical, pharmacy, and nursing education.

Methods: The Health Care Provider Committee of the Canadian Medication Appropriateness and Deprescribing Network conducted a literature search regarding deprescribing education, frameworks for prescribing and deprescribing, and then proposed competencies and curriculum structures that could embed the competencies.

Results: A framework was structured around a published 5-step deprescribing process and integrated with two international competency frameworks for prescribing. A total of 7 competencies are proposed (e.g. starting with gathering and interpreting patient information, including weighing benefits and harms to make shared decisions and then implementing monitoring for deprescribing interventions). A distribution based on early, mid, and advanced learners was structured for all competencies. Teaching and assessment strategies are provided as examples where appropriate for each profession. A 4-6-year implementation plan is proposed for programs to map their curriculum, identify gaps and create opportunities to integrate deprescribing education.

Conclusions: An interprofessional curriculum framework for deprescribing was developed with supporting framework structures from prescribing frameworks. Educators specializing in geriatrics can use the framework to implement curriculum in the professions of medicine, pharmacy, and nursing.