Journal article
Challenges and opportunities in creating a deprescribing program in the emergency department: A qualitative study
Journal of the American Geriatrics Society (JAGS), Vol.71(1), pp.62-76
01/2023
DOI: 10.1111/jgs.18047
PMCID: PMC10092723
PMID: 36258309
Appears in UI Libraries Support Open Access
Abstract
BACKGROUND As the population of older adults increases, appropriate deprescribing becomes increasingly important for emergency geriatric care. Older adults represent the sickest patients with chronic medical conditions, and they are often exposed to high-risk medications. We need to provide an evidence-based, standardized deprescribing program in the acute care setting, yet the evidence base is lacking and standardized medication programs are needed. METHODS We conducted a qualitative study with the goal to understand the perspective of healthcare workers, patients, and caregivers on deprescribing high-risk medications in the context of emergency care practices, provider preferences, and practice variability, along with the facilitators and barriers to an effective deprescribing program in the emergency department (ED). To ensure rich, contextual data, the study utilized two qualitative methods: (1) a focus group with physicians, advanced practice providers, nurses, pharmacists, and geriatricians involved in care of older adults and their prescriptions in the acute care setting; (2) semi-structured interviews with patients and caregivers involved in treatment and emergency care. Transcriptions were coded using thematic content analysis, and the principal investigator (S.L.) and trained research staff categorized each code into themes. RESULTS Data collection from a focus group with healthcare workers (n = 8) and semi-structured interviews with patients and caregivers (n = 20) provided evidence of a potentially promising ED medication program, aligned with the vision of comprehensive care of older adults, that can be used to evaluate practices and develop interventions. We identified four themes: (1) Challenges in medication history taking, (2) missed opportunities in identifying high-risk medications, (3) facilitators and barriers to deprescribing recommendations, and (4) how to coordinate deprescribing recommendations. CONCLUSIONS Our focus group and semi-structured interviews resulted in a framework for an ED medication program to screen, identify, and deprescribe high-risk medications for older adults and coordinate their care with primary care providers.
Details
- Title: Subtitle
- Challenges and opportunities in creating a deprescribing program in the emergency department: A qualitative study
- Creators
- Sangil Lee - Roy J. and Lucille A. Carver College of MedicineMorgan Bobb SwansonAllison Fillman - Roy J. and Lucille A. Carver College of MedicineRyan M Carnahan - University of IowaAaron T Seaman - Roy J. and Lucille A. Carver College of MedicineHeather Schacht Reisinger - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.71(1), pp.62-76
- DOI
- 10.1111/jgs.18047
- PMID
- 36258309
- PMCID
- PMC10092723
- NLM abbreviation
- J Am Geriatr Soc
- eISSN
- 1532-5415
- Publisher
- Wiley
- Language
- English
- Electronic publication date
- 10/18/2022
- Date published
- 01/2023
- Academic Unit
- Epidemiology; Emergency Medicine; Nursing; Center for Social Science Innovation; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984306252002771
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