Development of a behaviour change intervention for deprescribing for older people in secondary care in Saudi Arabia

Determinants were prioritised and mapped to behaviour change techniques (BCTs). A modified nominal group technique used the APEASE criteria (Acceptability, Practicability, Effectiveness, Affordability, Side effects and safety, and Equity) to refine and select BCTs. A cross-sectional survey using the revised Patients’ Attitudes Towards Deprescribing questionnaire assessed older inpatients’ and carers’ views.

Finally, a scoping review applied the Behaviour Change Wheel to map hospital interventions to functions and BCTs.<br><br>Results<br>Key determinants included professional roles, team and hierarchical influences, patient and carer perceptions, concerns about negative outcomes, lack of guidance and documentation, resource constraints, interprofessional support, education, and recognition of benefits. These were linked to six TDF2 domains.

Five BCTs were selected: ‘Information about others’ approval’, ‘Social support’, ‘Information about health consequences’, ‘Social comparison’, and ‘Salience of consequences’. Most older inpatients (88.1%) and carers (82.7%) were willing to deprescribe if recommended by a healthcare professional and wanted involvement in decision-making.<br><br>Conclusion<br>This thesis provides a theory-informed foundation for a feasible hospital-based deprescribing intervention in Saudi Arabia.

The selected BCTs offer a practical basis for future intervention development, testing, and integration into routine hospital practice.<br><br><i>Thesis embargoed until 31st July 2031</i><br>