Table 3 Factors affecting a General Practitioner’s deprescribing behaviour

Environmental factors

Working within a complex system

“So lack of uniformity of medication documentation is a barrier.” (AusGP3)

“I am pretty stressed when I am come back to the PHCC from the ACF. It limits me to not have the computer system to work with at the ACF, therefore I have to bring back a lot of work to administrate when I come back to the PHCC.” (SweGP6)

Communication

“You’re stopping people’s blood pressure medication and then to Digoxin and things like that. To me what that means is then unless you then identify a palliative care situation and everybody’s happy with that, is that means more monitoring, more faxes, more this, more that.” (AusGP3)

“I feel that it takes a lot of patience and ability to cooperate with the other staff at the ACF.” (SweGP2)

Financial incentives to providing care

“They will all complain bitterly about the doctors because we’re always - well, I am - always grumpy and never want to be there because you feel like you’re virtually doing charity work because you work hard.” (AusGP4)

Skills and ability

Quality of human resources

“The issue is as well is that the nursing staff have got to have the capacity to actually adhere to the plan.” (AusGP4)

“I would like more nursing staff, better educated nursing staff. It is my belief that we could save a lot of time and money that way.” (SweGP2)

Quantity of human resources

“The institution has to respect the [prescribing] policy and have enough skill to actually adhere to it.” (AusGP6)

“It is not optimal that a patient gets a sedative drug instead of someone that holds her hand, but it is as good as it can get because there is no other way. That is frustrating of course, and sad, that I can’t influence this in any way” (SweGP2)