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. 2025 Aug;81(8):1155-1165.
doi: 10.1007/s00228-025-03852-4. Epub 2025 May 31.

Attitudes, barriers, and facilitators toward tools supporting appropriate prescribing among healthcare professionals: a cross-sectional study

Monia Donati #  1 , Valentina Giunchi #  1 , Giulia Grillini  1 , Marco Domenicali  1 , Maria Lia Lunardelli  2 , Veronica Pasini  3 , Susy Milandri  4 , Monica Mussoni  5 , Fabio Pieraccini  5 , Elisa Sangiorgi  6 , Emanuel Raschi  1 , Valentina Colonnello  1 , Carlotta Lunghi  7   8 , Elisabetta Poluzzi  1
Affiliations

Attitudes, barriers, and facilitators toward tools supporting appropriate prescribing among healthcare professionals: a cross-sectional study

Monia Donati et al. Eur J Clin Pharmacol. 2025 Aug.

Abstract

Purpose: Potentially inappropriate prescriptions are associated with an increased risk of drug-drug interactions, adverse events, and unfavorable clinical outcomes, especially in older adults. Although different tools to improve appropriate prescribing have been developed to support healthcare professionals, their application and the barriers to their use remain insufficiently explored. This study aimed to assess Italian healthcare professionals' knowledge of these tools and identify obstacles to their adoption.

Methods: The study used a purposefully designed questionnaire to assess knowledge, adoption, and barriers related to appropriateness tools. The tools included were identified through a literature review and subsequently refined via expert consensus. Open-ended responses were analyzed using a conventional content analysis approach, and the analyses focused on differences across professional groups.

Results: The survey collected 657 responses from pharmacists (35%), nurses (26%), general practitioners (22%), geriatricians/internists (9%), and other physicians (8%). The Beers and STOPP/START criteria were used by 38% and 34% of participants, respectively, with geriatricians and other physicians being the primary users. Additionally, 34% of participants reported using specific software integrated into their institutional computer systems. Among 294 respondents identifying barriers to appropriate prescribing, the most common were lack of time (14%), lack of knowledge (10%), and accessibility/costs of digital tools (8%). Key facilitators included specific training (38%), integrated software/apps (29%), and more time with patients (11%).

Conclusions: The adoption of tools supporting appropriate prescribing remains limited among healthcare professionals in Italy, with significant differences among professionals. Policymakers and healthcare institutions should focus on education, interprofessional collaboration, and user-friendly digital solutions to improve prescribing process and patient safety.

Keywords: Appropriate prescribing; Drug-drug interactions; Healthcare professionals; Medication safety; Polypharmacy; Prescribing tools.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Usage and knowledge of each appropriateness tool
Fig. 2
Fig. 2
Use of each appropriateness tool by profession
Fig. 3
Fig. 3
Interplay between barriers and proposed solutions (facilitators)
See this image and copyright information in PMC

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