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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

17.08.2022 | Reports of Original Investigations

Identifying barriers and facilitators to routine preoperative frailty assessment: a qualitative interview study

verfasst von: Emily Hladkowicz, MEd, Kristin Dorrance, MSc, Gregory L. Bryson, MD, MSc, FRCPC, Alan Forster, MD, MSc, FRCPC, Sylvain Gagne, MD, FRCPC, Allen Huang, MDCM, FRCPC, Manoj M. Lalu, MD, PhD, FRCPC, Luke T. Lavallée, MD, MSc, FRCSC, Husein Moloo, MD, MSc, FRCSC, Janet Squires, RN, PhD, Daniel I. McIsaac, MD, MPH, FRCPC

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 11/2022

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Abstract

Purpose

Preoperative frailty assessment is recommended by multiple practice guidelines and may improve outcomes, but it is not routinely performed. The barriers and facilitators of routine preoperative frailty assessment have not been formally assessed. Our objective was to perform a theory-guided evaluation of barriers and facilitators to preoperative frailty assessment.

Methods

This was a research ethics board-approved qualitative study involving physicians who perform preoperative assessment (consultant and resident anesthesiologists and consultant surgeons). Semistructured interviews were conducted by a trained research assistant informed by the Theoretical Domains Framework to identify barriers and facilitators to frailty assessment. Interview transcripts were independently coded by two research assistants to identify specific beliefs relevant to each theoretical domain.

Results

We interviewed 28 clinicians (nine consultant anesthesiologists, nine consultant surgeons, and ten anesthesiology residents). Six domains (Knowledge [100%], Social Influences [96%], Social Professional Role and Identity [96%], Beliefs about Capabilities [93%], Goals [93%], and Intentions [93%]) were identified by > 90% of respondents. The most common barriers identified were prioritization of other aspects of assessment (e.g., cardio/respiratory) and a lack of awareness of evidence and guidelines supporting frailty assessment. The most common facilitators were a high degree of familiarity with frailty, recognition of the importance of frailty assessment, and strong intentions to perform frailty assessment.

Conclusion

Barriers and facilitators to preoperative frailty assessment are multidimensional, but generally consistent across different types of perioperative physicians. Knowledge of barriers and facilitators can guide development of evidence-based strategies to increase frailty assessment.

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Titel: Identifying barriers and facilitators to routine preoperative frailty assessment: a qualitative interview study
verfasst von: Emily Hladkowicz, MEd
Kristin Dorrance, MSc
Gregory L. Bryson, MD, MSc, FRCPC
Alan Forster, MD, MSc, FRCPC
Sylvain Gagne, MD, FRCPC
Allen Huang, MDCM, FRCPC
Manoj M. Lalu, MD, PhD, FRCPC
Luke T. Lavallée, MD, MSc, FRCSC
Husein Moloo, MD, MSc, FRCSC
Janet Squires, RN, PhD
Daniel I. McIsaac, MD, MPH, FRCPC
Publikationsdatum: 17.08.2022
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 11/2022
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02298-x

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Identifying barriers and facilitators to routine preoperative frailty assessment: a qualitative interview study