Barriers and enablers of older adults initiating a deprescribing conversation.

Abstract

OBJECTIVE\nTo examine older adults perceptions and identify barriers and enablers to initiating a conversation about stopping medication(s) with their healthcare provider.\n\n\nMETHODS\nWe conducted one focus group (n\xa0=\xa03) and in-depth, face-to-face, individual interviews (n\xa0=\xa06) 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.\n\n\nRESULTS\nFive 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 (Themes 4-5) identified enablers including strategies to promote older adults self-efficacy and improved healthcare communication.\n\n\nCONCLUSION\nConsumer-centric tools could improve older adults self-efficacy to initiate deprescribing conversations.\n\n\nPRACTICE IMPLICATIONS\nRemoving 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.