手术前停药的障碍和促进因素：对提供者和老年人的定性研究。
Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults.
机构信息
Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205.
Medstar Georgetown University, 3800 Reservoir Road NW, Washington, DC, 20007, USA.
出版信息
Geriatr Nurs. 2023 Sep-Oct;53:135-140. doi: 10.1016/j.gerinurse.2023.07.018. Epub 2023 Aug 2.
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.
简介
在患有多种疾病的老年人中，通过提供者和患者之间的协作来简化药物治疗方案的药物停用（deprescribing），可能会降低手术后发生不良事件的风险。但是，针对手术进行药物停用的障碍和促进因素尚未得到探索。
方法
我们对计划接受手术的 65 岁及以上的初级保健提供者（PCP）和患者进行了一项定性研究。我们使用了理论领域框架，为访谈指南和分析提供了信息。
结果
共纳入 16 名参与者（n=8 名提供者，n=8 名患者）。主题包括：1）手术前对药物停用的态度，2）手术前药物停用的预期益处，3）医患关系和共同决策，4）对手术的希望，5）手术前药物停用的障碍，以及 6）对药物停用随访的偏好。
结论
我们关于手术前药物停用的提供者和患者相关障碍和促进因素以及期望过程的研究结果，可能为未来的手术前药物停用干预目标提供信息。
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