Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults

Ji Won Lee; Suin Jeong; Hae Ra Han; Cynthia M. Boyd; Nancy Perrin; Sandra Faye Simmons; Ariel R. Green; Janiece L. Taylor; Henry R. Boucher; Sarah L. Szanton

doi:10.1016/j.gerinurse.2023.07.018

Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults

Ji Won Lee, Suin Jeong, Hae Ra Han, Cynthia M. Boyd, Nancy Perrin, Sandra Faye Simmons, Ariel R. Green, Janiece L. Taylor, Henry R. Boucher, Sarah L. Szanton

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Deprescribing, the collaborative process between providers and patients to streamline medication regimen, may reduce the risk of adverse events following surgery among older adults with multimorbidity. However, barriers and facilitators to deprescribing for surgery has not been explored. Methods: We conducted a qualitative study of Primary Care Providers (PCP) and patients aged 65 and older who were scheduled for surgery. We used the Theoretical Domains Framework, which informed the interview guide and analysis. Results: A total of 16 participants (n=8 providers, n=8 patients) were included. Themes were regarding: 1) attitudes towards deprescribing before surgery, 2) perceived benefits of deprescribing before surgery, 3) patient-provider relationship and shared decision-making, 4) hope for surgery, 5) barriers to deprescribing before surgery, and 6) preferences for deprescribing follow-up. Conclusion: Our study findings regarding provider- and patient-related barriers and facilitators for deprescribing and desired processes before surgery may inform future deprescribing intervention targets before surgery.

Original language	English (US)
Pages (from-to)	135-140
Number of pages	6
Journal	Geriatric Nursing
Volume	53
DOIs	https://doi.org/10.1016/j.gerinurse.2023.07.018
State	Published - Sep 1 2023

Keywords

Deprescribing
Older adults
Providers
Surgery

ASJC Scopus subject areas

Gerontology

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10.1016/j.gerinurse.2023.07.018

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title = "Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults",

abstract = "Introduction: Deprescribing, the collaborative process between providers and patients to streamline medication regimen, may reduce the risk of adverse events following surgery among older adults with multimorbidity. However, barriers and facilitators to deprescribing for surgery has not been explored. Methods: We conducted a qualitative study of Primary Care Providers (PCP) and patients aged 65 and older who were scheduled for surgery. We used the Theoretical Domains Framework, which informed the interview guide and analysis. Results: A total of 16 participants (n=8 providers, n=8 patients) were included. Themes were regarding: 1) attitudes towards deprescribing before surgery, 2) perceived benefits of deprescribing before surgery, 3) patient-provider relationship and shared decision-making, 4) hope for surgery, 5) barriers to deprescribing before surgery, and 6) preferences for deprescribing follow-up. Conclusion: Our study findings regarding provider- and patient-related barriers and facilitators for deprescribing and desired processes before surgery may inform future deprescribing intervention targets before surgery.",

keywords = "Deprescribing, Older adults, Providers, Surgery",

author = "Lee, {Ji Won} and Suin Jeong and Han, {Hae Ra} and Boyd, {Cynthia M.} and Nancy Perrin and Simmons, {Sandra Faye} and Green, {Ariel R.} and Taylor, {Janiece L.} and Boucher, {Henry R.} and Szanton, {Sarah L.}",

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year = "2023",

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doi = "10.1016/j.gerinurse.2023.07.018",

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T2 - A qualitative study of providers and older adults

AU - Lee, Ji Won

AU - Jeong, Suin

AU - Han, Hae Ra

AU - Boyd, Cynthia M.

AU - Perrin, Nancy

AU - Simmons, Sandra Faye

AU - Green, Ariel R.

AU - Taylor, Janiece L.

AU - Boucher, Henry R.

AU - Szanton, Sarah L.

PY - 2023/9/1

Y1 - 2023/9/1

N2 - Introduction: Deprescribing, the collaborative process between providers and patients to streamline medication regimen, may reduce the risk of adverse events following surgery among older adults with multimorbidity. However, barriers and facilitators to deprescribing for surgery has not been explored. Methods: We conducted a qualitative study of Primary Care Providers (PCP) and patients aged 65 and older who were scheduled for surgery. We used the Theoretical Domains Framework, which informed the interview guide and analysis. Results: A total of 16 participants (n=8 providers, n=8 patients) were included. Themes were regarding: 1) attitudes towards deprescribing before surgery, 2) perceived benefits of deprescribing before surgery, 3) patient-provider relationship and shared decision-making, 4) hope for surgery, 5) barriers to deprescribing before surgery, and 6) preferences for deprescribing follow-up. Conclusion: Our study findings regarding provider- and patient-related barriers and facilitators for deprescribing and desired processes before surgery may inform future deprescribing intervention targets before surgery.

AB - Introduction: Deprescribing, the collaborative process between providers and patients to streamline medication regimen, may reduce the risk of adverse events following surgery among older adults with multimorbidity. However, barriers and facilitators to deprescribing for surgery has not been explored. Methods: We conducted a qualitative study of Primary Care Providers (PCP) and patients aged 65 and older who were scheduled for surgery. We used the Theoretical Domains Framework, which informed the interview guide and analysis. Results: A total of 16 participants (n=8 providers, n=8 patients) were included. Themes were regarding: 1) attitudes towards deprescribing before surgery, 2) perceived benefits of deprescribing before surgery, 3) patient-provider relationship and shared decision-making, 4) hope for surgery, 5) barriers to deprescribing before surgery, and 6) preferences for deprescribing follow-up. Conclusion: Our study findings regarding provider- and patient-related barriers and facilitators for deprescribing and desired processes before surgery may inform future deprescribing intervention targets before surgery.

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KW - Older adults

KW - Providers

KW - Surgery

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Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults

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Keywords

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