Barriers and enablers of older adults initiating a deprescribing conversation
Date
2022
Authors
Ailabouni, N.J.
Weir, K.R.
Reeve, E.
Turner, J.T.
Wilson Norton, J.
Gray, S.L.
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Journal article
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Patient Education and Counseling, 2022; 105(3):615-624
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Abstract
Objective: To examine older adults’ perceptions and identify barriers and enablers to initiating a conversation about stopping medication(s) with their healthcare provider.Methods: We conducted one focus group (n = 3) and in-depth, face-to-face, individual interviews (n = 6) using an interview guide. Older adults aged ≥65 years in a retirement community who were taking ≥5 medications were recruited. Focus groups and interviews were audio-recorded and transcribed verbatim.Both a deductive analysis, informed by the Theoretical Domains Framework, and an inductive analysis were conducted. Results: Five themes and fourteen sub-themes were identified. Theme 1, ‘older adult-related barriers’,discusses limited or varying self-efficacy, past unsuccessful deprescribing experiences and limited familiarity with medications/deprescribing. Theme 2, ‘provider-related barriers’, discusses trust, short office visits, lack of communication and multiple providers. Theme 3, ‘environmental/social-related barriers’,involves limited availability of resources and access to telehealth/internet. The remaining themes (Themes4–5) identified enablers including strategies to promote older adults’ self-efficacy and improved health care communication. Conclusion: Consumer-centric tools could improve older adults’ self-efficacy to initiate deprescribing conversations. Practice Implications: Removing barriers and implementing enablers may empower older adults to initiate deprescribing conversations with providers to take fewer medications. Ultimately, this could be a catalyst for increased translation of deprescribing in practice.
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Copyright 2021 Elsevier