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Exploring how GPs discuss statin deprescribing with older people: a qualitative study

BACKGROUND: Given uncertainty surrounding benefits and harms, shifts in patient health status, and changing patient goals and preferences, statin deprescribing may be considered in some older people. This decision should be carefully discussed between GPs and patients. AIM: To explore how GPs discus...

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Autores principales: Thompson, Wade, Le, Jette Videbæk, Haastrup, Peter, Nielsen, Jesper Bo, Pedersen, Line Bjørnskov, Jarbøl, Dorte Ejg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of General Practitioners 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330200/
https://www.ncbi.nlm.nih.gov/pubmed/32238392
http://dx.doi.org/10.3399/bjgpopen20X101022
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author Thompson, Wade
Le, Jette Videbæk
Haastrup, Peter
Nielsen, Jesper Bo
Pedersen, Line Bjørnskov
Jarbøl, Dorte Ejg
author_facet Thompson, Wade
Le, Jette Videbæk
Haastrup, Peter
Nielsen, Jesper Bo
Pedersen, Line Bjørnskov
Jarbøl, Dorte Ejg
author_sort Thompson, Wade
collection PubMed
description BACKGROUND: Given uncertainty surrounding benefits and harms, shifts in patient health status, and changing patient goals and preferences, statin deprescribing may be considered in some older people. This decision should be carefully discussed between GPs and patients. AIM: To explore how GPs discuss deprescribing of statins with their older patients. DESIGN & SETTING: A qualitative study was undertaken using face-to-face, semi-structured interviews with Danish GPs from the regions of Southern Demark and Zealand. METHOD: The GP participants belonged to group practices and were identified from personal networks and snowballing. The interviews lasted approximately 30 minutes and were conducted in English. They were analysed using systematic text condensation. RESULTS: A total of 11 GPs were interviewed and three themes were identified. (1) Reason for initiating a discussion: statin deprescribing mainly came up when GPs reviewed medication lists. There were differences between GPs regarding when or if they brought up deprescribing. (2) Discussion topics: GPs often discussed their interpretation of evidence surrounding statin use in older people. There were differences in how and if GPs discussed patient preferences. GPs viewed uncertainty and life expectancy as difficult to discuss. (3) Depth of discussion: the perceived level of patient engagement, and clinical context, could influence the extent of discussion. CONCLUSION: GPs identified a range of topics that could be discussed with patients surrounding statin deprescribing. The depth and content of discussions varied according to the situation, and between GPs. Challenges may exist in communicating around certain topics, such as uncertainty and life expectancy. Further understanding of how to best communicate around challenging topics, and development of structured frameworks, may help facilitate statin deprescribing discussions. Identifying what patients think is important to discuss would provide necessary insight to promote quality discussions and shared understanding of the decision.
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spelling pubmed-73302002020-07-07 Exploring how GPs discuss statin deprescribing with older people: a qualitative study Thompson, Wade Le, Jette Videbæk Haastrup, Peter Nielsen, Jesper Bo Pedersen, Line Bjørnskov Jarbøl, Dorte Ejg BJGP Open Research BACKGROUND: Given uncertainty surrounding benefits and harms, shifts in patient health status, and changing patient goals and preferences, statin deprescribing may be considered in some older people. This decision should be carefully discussed between GPs and patients. AIM: To explore how GPs discuss deprescribing of statins with their older patients. DESIGN & SETTING: A qualitative study was undertaken using face-to-face, semi-structured interviews with Danish GPs from the regions of Southern Demark and Zealand. METHOD: The GP participants belonged to group practices and were identified from personal networks and snowballing. The interviews lasted approximately 30 minutes and were conducted in English. They were analysed using systematic text condensation. RESULTS: A total of 11 GPs were interviewed and three themes were identified. (1) Reason for initiating a discussion: statin deprescribing mainly came up when GPs reviewed medication lists. There were differences between GPs regarding when or if they brought up deprescribing. (2) Discussion topics: GPs often discussed their interpretation of evidence surrounding statin use in older people. There were differences in how and if GPs discussed patient preferences. GPs viewed uncertainty and life expectancy as difficult to discuss. (3) Depth of discussion: the perceived level of patient engagement, and clinical context, could influence the extent of discussion. CONCLUSION: GPs identified a range of topics that could be discussed with patients surrounding statin deprescribing. The depth and content of discussions varied according to the situation, and between GPs. Challenges may exist in communicating around certain topics, such as uncertainty and life expectancy. Further understanding of how to best communicate around challenging topics, and development of structured frameworks, may help facilitate statin deprescribing discussions. Identifying what patients think is important to discuss would provide necessary insight to promote quality discussions and shared understanding of the decision. Royal College of General Practitioners 2020-04-01 /pmc/articles/PMC7330200/ /pubmed/32238392 http://dx.doi.org/10.3399/bjgpopen20X101022 Text en Copyright © 2020, The Authors https://creativecommons.org/licenses/by/4.0/ This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Research
Thompson, Wade
Le, Jette Videbæk
Haastrup, Peter
Nielsen, Jesper Bo
Pedersen, Line Bjørnskov
Jarbøl, Dorte Ejg
Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title_full Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title_fullStr Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title_full_unstemmed Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title_short Exploring how GPs discuss statin deprescribing with older people: a qualitative study
title_sort exploring how gps discuss statin deprescribing with older people: a qualitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330200/
https://www.ncbi.nlm.nih.gov/pubmed/32238392
http://dx.doi.org/10.3399/bjgpopen20X101022
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