(1172) Exploring Deprescribing Experiences of Older Veterans

Objectives:

Background: Patient experiences during a medical visit has been described as a process indicator that reflects the interpersonal aspects of healthcare quality such as receiving effective communication, respect and dignity, and emotional support. Assessing a patient’s experience after an intervention such as deprescribing is essential for health quality improvement. Yet, qualitative studies exploring older adults’ experiences after deprescribing interventions are sparse.

Aim: The aims of this study are to:
1. Assess the veteran’s reported experience of a focused deprescribing intervention.
2. Identify what was most important to them during the visit and whether it was achieved.
3. Explore challenges and opportunities to improve deprescribing process.

Methods: 15 - 20 Veterans aged 65 and older with comorbidities who have recently had a deprescribing intervention are interviewed to explore their experience with the intervention. Data was collected through individual semi-structured interviews lasting between 30 - 45 minutes by the lead investigator. An interview guide was used to direct the conversation. Questions explored include: 1) What kind of suggestions did the pharmacist make about your medications? 2) What did you think of the suggestions from the pharmacist? 3) What was most challenging to you about the conversation with the pharmacist? An iterative process is used between initial data collection, analysis, and interview guide revision. Interview transcripts will be analyzed using qualitative content analysis by two research team members independently. Categories and themes will be coded using inductive and deductive content analysis. Deductive analysis will follow the Self Determination Theory to assess the communication between the veteran and their providers including the veteran’s knowledge and skills. In addition, inductive content analysis will be done using open coding to identify new categories and themes. Coders will collaborate to identify similarities, discuss divergences, and resolve discrepancies. Veterans who agree to be contacted after the data analysis will be mailed a coded transcript of their response to verify that the interpretation of the data into codes and categories was accurately done. Data overlaps in the responses between participants will also be analyzed after coding to assess the thick description of the data. Through an abstraction process, content-characteristics of words will describe the categories and clusters to create a general description of the research topic.

Results: Veterans will have provided insights on how the process, structure, and outcomes of deprescribing can be improved.

Conclusions: An exploration of the veteran’s reported experience will provide recommendations to improve the quality of the deprescribing program.