Tailoring an implementation strategy for deprescribing as part of a Comprehensive Geriatric Assessment (dCGA) in long-term care facilities: A roundtable discussion

Background: Comprehensive geriatric assessments (CGAs), with deprescribing as an integral component, improve outcomes for older adults in long-term care facilities (LTCFs). However, they remain underutilised in Croatia, partly due to systemic and cultural barriers, including limited recognition of pharmacists' roles. Objective: To tailor an existing deprescribing implementation strategy to support the introduction of deprescribing as part of a CGA (dCGA) in Croatian LTCFs, focusing on healthcare professional (HCP) behaviour change. Methods: A roundtable was held with Croatian HCPs—general practitioners, pharmacists and a nurse—experienced in LTCF care. Participants first ranked barriers and enablers to dCGA, then engaged in a structured discussion to explore tailored strategies. Results: Key barriers included limited resources, fragmented data and restrictive policies. Enablers included multidisciplinary collaboration and education. A three-phase strategy (pre-, during, post-MDT) was developed, assigning the head nurse as dCGA lead and positioning pharmacists as deprescribing experts and trainers. Proposed mechanisms targeted priority barriers using Behaviour Change Techniques such as restructuring the social environment, goal setting and feedback loops. Conclusion: This study co-developed a feasible, context-specific strategy to integrate deprescribing into CGA in Croatian LTCFs. Future steps include pilot testing and evaluation in diverse LTCF settings.