O'Halloran Tessa, Colquhoun Jessie, Danjoux Gerard, Partridge Judith Sl, Dhesi Jugdeep K
Guy's and St Thomas' NHS Foundation Trust, London, UK;
Lewisham and Greenwich NHS Trust, London, UK.
Clin Med (Lond). 2021 Mar;21(2):e192-e197. doi: 10.7861/clinmed.2020-0851.
Perioperative optimisation can improve outcomes for older people having surgery. Integration with primary care could improve quality and reduce variability in access to preoperative optimisation.
Our aim was to explore attitudes, beliefs and behaviours of general practitioners (GPs) regarding the perioperative pathway, and evaluate enablers and barriers to GP-led preoperative optimisation.
Stakeholder interviews (n=38) informed survey development. A purposive sampling frame was used to target delivery of online and paper surveys. Results were analysed using descriptive statistics.
We had 231 responses (response rate 32.7%). Enablers included belief among GPs that optimisation improves postoperative outcomes (86%) and that they have a role discussing modifiable risk factors with patients (85%). Barriers included low frequency exposure to older surgical patients, minimal training in perioperative medicine and rare interaction with perioperative services.
This survey illustrates the importance of interprofessional education, cross-sector training opportunities and collaboration to deliver integrated preoperative optimisation for older people undergoing surgery.
围手术期优化可改善老年手术患者的预后。与初级保健相结合可提高质量并减少术前优化服务获取方面的差异。
我们的目的是探讨全科医生（GP）对围手术期路径的态度、信念和行为，并评估由全科医生主导的术前优化的促进因素和障碍。
利益相关者访谈（n = 38）为调查问卷的制定提供了信息。采用目的抽样框架来进行在线和纸质调查。使用描述性统计分析结果。
我们共收到231份回复（回复率32.7%）。促进因素包括全科医生相信优化可改善术后预后（86%）以及他们认为自己有责任与患者讨论可改变的风险因素（85%）。障碍包括接触老年手术患者的频率低、围手术期医学方面的培训极少以及与围手术期服务的互动很少。
本次调查说明了跨专业教育、跨部门培训机会以及合作对于为接受手术的老年人提供综合术前优化的重要性。
