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Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies.

Publication ,  Journal Article
Little, MO; Hecker, EJ; Colon-Emeric, CS; Herndon, L; McConnell, ES; Xue, TM; Berry, SD
Published in: BMC Nurs
January 31, 2023

BACKGROUND: Deprescribing initiatives in the long-term care (LTC) setting are often unsuccessful or not sustained. Prior research has considered how physicians and pharmacists feel about deprescribing, yet little is known about the perspectives of frontline nursing staff and residents. Our aim was to elicit perspectives from LTC nursing staff, patients, and proxies regarding their experiences and preferences for deprescribing in order to inform future deprescribing efforts in LTC. METHODS: This study was a qualitative analysis of interviews with nurses, nurse aides, a nurse practitioner, residents, and proxies (family member and/or responsible party) from three LTC facilities. The research team used semi-structured interviews. Guides were designed to inform an injury prevention intervention. Interviews were recorded and transcribed. A qualitative framework analysis was used to summarize themes related to deprescribing. The full study team reviewed the summary to identify actionable, clinical implications. RESULTS: Twenty-six interviews with 28 participants were completed, including 11 nurse aides, three residents, seven proxies, one nurse practitioner, and six nurses. Three themes emerged that were consistent across facilities: 1) build trust with team members, including residents and proxies; 2) identify motivating factors that lead to resident, proxy, nurse practitioner, and staff acceptance of deprescribing; 3) standardize supportive processes to encourage deprescribing. These themes suggest several actionable steps to improve deprescribing initiatives including: 1) tell stories about successful deprescribing, 2) provide deprescribing education to frontline staff, 3) align medication risk/benefit discussions with what matters most to the resident, 4) standardize deprescribing monitoring protocols, 5) standardize interprofessional team huddles and care plan meetings to include deprescribing conversations, and 6) strengthen non-pharmacologic treatment programs. CONCLUSIONS: By interviewing LTC stakeholders, we identified three important themes regarding successful deprescribing: Trust, Motivating Factors, and Supportive Processes. These themes may translate into actionable steps for clinicians and researchers to improve and sustain person-centered deprescribing initiatives. TRIAL REGISTRATION: NCT04242186.

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Published In

BMC Nurs

DOI

ISSN

1472-6955

Publication Date

January 31, 2023

Volume

22

Issue

1

Start / End Page

27

Location

England

Related Subject Headings

  • Nursing
  • 4205 Nursing
  • 4204 Midwifery
  • 1110 Nursing
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Little, M. O., Hecker, E. J., Colon-Emeric, C. S., Herndon, L., McConnell, E. S., Xue, T. M., & Berry, S. D. (2023). Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies. BMC Nurs, 22(1), 27. https://doi.org/10.1186/s12912-023-01179-y
Little, Milta O., Emily J. Hecker, Cathleen S. Colon-Emeric, Laurie Herndon, Eleanor S. McConnell, Tingzhong Michelle Xue, and Sarah D. Berry. “Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies.BMC Nurs 22, no. 1 (January 31, 2023): 27. https://doi.org/10.1186/s12912-023-01179-y.
Little MO, Hecker EJ, Colon-Emeric CS, Herndon L, McConnell ES, Xue TM, et al. Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies. BMC Nurs. 2023 Jan 31;22(1):27.
Little, Milta O., et al. “Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies.BMC Nurs, vol. 22, no. 1, Jan. 2023, p. 27. Pubmed, doi:10.1186/s12912-023-01179-y.
Little MO, Hecker EJ, Colon-Emeric CS, Herndon L, McConnell ES, Xue TM, Berry SD. Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies. BMC Nurs. 2023 Jan 31;22(1):27.
Journal cover image

Published In

BMC Nurs

DOI

ISSN

1472-6955

Publication Date

January 31, 2023

Volume

22

Issue

1

Start / End Page

27

Location

England

Related Subject Headings

  • Nursing
  • 4205 Nursing
  • 4204 Midwifery
  • 1110 Nursing