There are times when researchers identify a concept or phenomenon which becomes widely known and used in many areas. The construct takes on a life beyond the original scholarship. An example of this is the notion of “emotional labour” coined by Arlie Russell Hochschild to describe the work of nurses and others when regulating their responses in stressful situations, and managing the demands of patients, families, and colleagues.1 Another case is the step-like “paradigm shifts” in which science advances through radical ruptures as new truths emerge in scientific communities.2
An example that is currently breaking through to common use is the concept of “mindlines,” coined by John Gabbay and Andree le May in an article published in The BMJ in 20043 and more thoroughly developed in their subsequent book, Practice-Based Evidence .4 Starting with a small ethnographic study in one general practice, they carefully describe how clinicians use different forms of knowledge in making
Deprescribing aims to reduce polypharmacy and inappropriate medication use. Both General Practitioners (GPs) and older adults have expressed a willingness to consider deprescribing. However, deprescribing is often deferred in practice. The aim of this study was to identify factors which influence GP and older adult decisions about deprescribing in primary care. Semi-structured interviews were used in this qualitative study, conducted in a regional area in Australia. Participants included GPs and adults aged 65 years or older, using five or more medications and living independently in the community. Data were collected between January 2018 and May 2019. Thematic analysis was used to analyse the verbatim transcribed interviews using NVivo 12. A total of 41 interviews were conducted, 25 with older adults and 16 with GPs. Four key themes influenced deprescribing decisions: views of ageing, shared decision-making, attitudes toward medication use and characteristics of the health care enviro