Self-Perceived Competencies, Knowledge, Skills, and Attitudes of Healthcare Professional Students in Deprescribing: A National Survey.

Abstract

Deprescribing effectively reduces overprescribing but remains underused in clinical practice. Education is key to improving uptake, yet limited research has examined how future healthcare professionals are being prepared. To evaluate the extent to which current education prepares future Belgian healthcare professionals for deprescribing and to identify factors associated with higher self-perceived competency. Cross-sectional online survey between April and June 2024. Undergraduate and postgraduate students in medicine, pharmacy, and nursing from Belgian universities and nursing schools. Self-perceived competencies (7 items), knowledge and skills (19 items) were assessed using items from Farrell's framework, and attitudes were measured using 25 items from a Theoretical Domains Framework-based questionnaire. Data were analyzed using descriptive statistics and linear regressions, with composite competency scores as outcomes and curriculum level, clinical experience, and deprescribing exposure as predictors. Open-ended responses were thematically coded. A total of 1777 responses were included (509 in medicine, 792 in pharmacy, and 476 in nursing). Exposure to deprescribing within the curriculum was common in medicine and pharmacy but rare in nursing. Among medicine and pharmacy students, greater self-reported exposure to deprescribing and more advanced academic level were significantly associated with higher self-perceived competency scores (p < 0.001). Across all groups, students reported higher confidence in the early steps of the deprescribing process and lower confidence in assessing the deprescribing potential of individual medications and implementing deprescribing plans. Attitudes were generally positive, with strong intentions to deprescribe, perceived benefits, and alignment with professional identity. Barriers included patient reluctance, competing priorities, and time constraints. Students recommended more practical and interprofessional education, introduced earlier and more broadly in the curriculum. Findings highlight encouraging self-reported competencies and reveal opportunities to strengthen deprescribing education, particularly in nursing programs, with greater emphasis on the later stages of the deprescribing process.