Community pharmacists' practices and perspectives on deprescribing high-risk psychotropic medicines: National survey findings.

AIM: To explore the practices, confidence and perspectives of community pharmacists in deprescribing high-risk psychotropic medicines, including opioid analgesics, benzodiazepine, gabapentinoids and medicinal cannabis.

METHODS

An anonymous, cross-sectional national online survey was conducted between January and April 2025 among Australian community pharmacists. The survey captured data on pharmacist demographics, their workplace (pharmacy) characteristics, their provision of high-risk psychotropic medicines, and pharmacists' perspectives, confidence and practices related to implementing strategies to support deprescribing of these medicines. Descriptive statistics and logistic regression analyses were conducted to explore the factors associated with initiating discussions with patients about deprescribing.

RESULTS

The sample comprised of 730 pharmacists, representing approximately 12% of all Australian community pharmacies. Approximately three-quarters indicated their pharmacy received prescriptions every day for opioids (80.6%), benzodiazepines (75.2%) and gabapentinoids (72.1%), whilst fewer than one-tenth of pharmacies (8.9%) received medicinal cannabis prescriptions every day. Pharmacists working outside of capital cities (i.e. other urban, rural or remote areas; adjusted odds ratio (aOR): 1.33, 95% confidence intervals (CIs): 0.97-1.83), pharmacy managers/owners (aOR: 1.29, 95% CIs: 1.22-1.50) and those with ≥ 15 years of professional experience (OR: 1.57, 95% CIs: 1.17-2.11) had higher odds of initiating discussions on deprescribing psychotropic medicines compared with those working in capital cities, employee pharmacists and those with <15 years of professional experience, respectively.

CONCLUSION

These findings provide some of the first insights into deprescribing practices of high-risk psychotropic medicines within community pharmacy settings, highlighting clear opportunities to strengthen these practices, particularly through supporting early-career pharmacists and those practicing in capital cities.