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

Geriatr Nurs. 2023 Sep-Oct:53:135-140. doi: 10.1016/j.gerinurse.2023.07.018. Epub 2023 Aug 2.

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Decision Making, Shared
  • Deprescriptions*
  • Humans
  • Polypharmacy
  • Qualitative Research