Fiest, KirstenJaworska, Natalia2022-07-192022-07-192022-07-09Jaworska, N. (2022). Facilitators and barriers to deprescribing antipsychotic medications in critically ill adult patients at transitions of care (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/114855Antipsychotic medications are prescribed to critically ill adult patients in the intensive care unit (ICU) for clinical indications including delirium, agitation, and sleep disturbances. While there is some evidence for their use in managing agitation, antipsychotic medications have not convincingly shown efficacy for the management of delirium or sleep and are often continued at transitions of care in critically ill patients when they may no longer be necessary or appropriate. The current literature on antipsychotic minimization and deprescribing in critically ill patients is sparse lacking evaluation of underlying facilitators and barriers informing current antipsychotic prescribing practices that may be important in the development of effective minimization and deprescribing strategies. The studies presented in this thesis address knowledge gaps regarding antipsychotic prescribing and deprescribing practices among inpatient healthcare professionals who care for patients with and following critical illness. Based on a qualitative study with semi-structured interviews of 21 healthcare professionals, seven relevant domains from the Theoretical Domains Framework (TDF) contributing to antipsychotic prescribing and deprescribing were identified. A subsequent scoping review of the literature identified differences between healthcare professional perceived and actual prescribing practices, with few in-hospital deprescribing strategies available to guide practice. Thereafter, a nationwide modified Delphi consensus process informed by the qualitative study and scoping review identified consensus statements for antipsychotic minimization activities and antipsychotic deprescribing strategies for patients with and following critical illness. The results of these studies characterize and catalogue relevant priority facilitators and barriers to antipsychotic minimization and deprescribing in critically ill adult patients during their hospitalization to support best clinical prescribing practices.engUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Health services researchAntipsychoticsCritical careBiophysics--MedicalChemistry--Pharmaceuticalmaster thesis10.11575/PRISM/39917