Adherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey
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Why the study?
While specific practices for perioperative care of older adults are recommended, adherence by US physician anesthesiologists to such practices was unknown.
Population
1737 ASA members who responded to a web-based questionnaire
Design
Web-based survey
Authors
Discussion
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Member takes
Implication
Survey data reveal gaps in recommended geriatric perioperative practices; leaves open whether education or protocols can increase adoption.
Key Points
- To characterize current clinical practices and adherence to recommended perioperative care guidelines for older surgical patients among US physician anesthesiologists.
- Administered a web-based questionnaire to 25,587 American Society of Anesthesiologists (ASA) members between May 24, 2018, and June 29, 2018.
- Evaluated practice proportions, adherence to geriatric recommendations, resource needs, and clinical practice characteristics among 1,737 respondents (6.8% response rate).
- Frequent use of multimodal analgesia (≥90% of the time) was reported by 47.1% of respondents (95% CI, 44.6% to 49.7%), while 25.5% (95% CI, 23.3% to 27.7%) routinely provided preoperative information on postoperative cognitive changes.
- Over 80% of respondents reported screening for frailty or dementia, screening postoperatively for delirium, or obtaining preoperative geriatric consultation in fewer than 10% of cases.
- Respondents prioritized the development of formal clinical guidelines and expanded web-based educational resources to improve geriatric perioperative anesthesia care.
Structured PICO
P
Population
1,737 US-based attending physician anesthesiologist ASA members in active practice
O
Outcome
Adherence to recommended practices for perioperative care of older adults (preoperative frailty screening, comprehensive geriatric evaluation, multimodal analgesia, preoperative cognitive screening, postoperative delirium screening, and provision of information regarding cognitive risks)
Limitations
- Low overall response rate (6.8%) implying potential missing data
- Selection bias (respondents more likely to have an interest in anesthesia for older adults)
- Social desirability bias ('faking good')
- Did not collect data from US physician anesthesiologists who were not ASA members
Cite This Study
Deiner et al. (2020) studied this question.
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