Evidence mapPaperPMID 37847423Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2023

Emotional barriers and facilitators of deprescribing for older adults with cancer and polypharmacy: a qualitative study.

Erika Ramsdale, Arul Malhotra, Holly M Holmes, Lisa Zubkoff, Jinjiao Wang, Supriya Mohile, Sally A Norton, Paul R Duberstein

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05046171 (Decreasing Polypharmacy in Older Adults With Curable Cancers), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05046171 phase1 / phase2completednot on this map

Decreasing Polypharmacy in Older Adults With Curable Cancers: a Pilot Cluster-randomized Trial

TypeinterventionalSponsorUniversity of RochesterRan2022 to 2025Enrolled50ConditionsCancerArmsPharmacist-led deprescribing, Patient education
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Erika RamsdaleJames P. Wilmot Cancer Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA. erika_ramsdale@urmc.rochester.edu.ORCID https://orcid.org/0000-0002-2246-168X
Arul MalhotraJames P. Wilmot Cancer Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Holly M HolmesDivision of Geriatric and Palliative Medicine, McGovern Medical School, Houston, TX, USA.
Lisa ZubkoffDepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Jinjiao WangSchool of Nursing, University of Rochester Medical Center, Rochester, NY, USA.
Supriya MohileJames P. Wilmot Cancer Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
Sally A NortonSchool of Nursing, University of Rochester Medical Center, Rochester, NY, USA.
Paul R DubersteinDepartment of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA.
University of Rochester Medical Center · USRutgers, The State University of New Jersey · USUniversity of Alabama at Birmingham · US

Funding

URCC NCORP Research BaseUG1CA189961 · UNIVERSITY OF ROCHESTER · 2025 to 2025
$5.6M
NCI NIH HHS UG1 CA189961
6 · The paper itself

Abstract

purposeTo describe emotional barriers and facilitators to deprescribing (the planned reduction or discontinuation of medications) in older adults with cancer and polypharmacy.

methodsVirtual focus groups were conducted over Zoom with 5 key informant groups: oncologists, oncology nurses, primary care physicians, pharmacists, and patients. All groups were video- and audio-recorded and transcribed verbatim. Focus group transcripts were analyzed using inductive content analysis, and open coding was performed by two coders. A codebook was generated based on the initial round of open coding and updated throughout the analytic process. Codes and themes were discussed for each transcript until consensus was reached. Emotion coding (identifying text segments expressing emotion, naming the emotion, and assigning a label of positive or negative) was performed by both coders to validate the open coding findings.

resultsAll groups agreed that polypharmacy is a significant problem. For clinicians, emotional barriers to deprescribing include fear of moral judgment from patients and colleagues, frustration toward patients, and feelings of incompetence. Oncologists and patients expressed ambivalence about deprescribing due to role expectations that physicians "heal with med[ication]s." Emotional facilitators of deprescribing included the involvement of pharmacists, who were perceived to be neutral, discerning experts. Pharmacists described emotionally aware communication strategies when discussing deprescribing with other clinicians and expressed increased awareness of patient context.

conclusionDeprescribing can elicit strong and predominantly negative emotions among clinicians and patients which could inhibit deprescribing interventions. The involvement of pharmacists in deprescribing interventions could mitigate these emotional barriers.

trial registrationClinicalTrials.gov Identifier: NCT05046171 . Date of registration: September 16, 2021.

Indexed as

DeprescriptionsNeoplasmsAgedAttitude of Health PersonnelEmotionsHumansPolypharmacyDeprescribingFocus groupsPharmacistsPolypharmacy

Identifiers

PMID37847423
PMCPMC10581937
OpenAlexW4387692924

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.