Provider Perspectives on Addressing Firearm Safety with Older Adults in Primary Care

ObjectivesChronic conditions, including mild cognitive impairment and depression, place older adults at high risk of firearm suicide. Approximately 40% of older adults have access to a firearm, and many do not store their firearms safely. However, firearm counseling occurs infrequently in clinical settings. Using by the Ottawa Decision Support Framework (ODSF) to conceptualize the decisional support needed by patients and their providers to facilitate firearm counseling, we explore provider perspectives on desired resources for addressing firearm safety with older adult patients.MethodsFrom March - August 2022, we conducted 21 semi-structured interviews with primary care providers caring for older adults. We report deductive concepts as well as emergent themes.ResultsMajor themes were identified from the three components of the ODSF; decisional needs, decision support and decisional outcomes. Themes included: provider self-efficacy to conduct firearm counseling, clinical workflow considerations, stories for change, patient diagnosis implications, and caregiver involvement.ConclusionsThere is a need for decision aids in the clinical setting that facilitate firearm counseling and promotes shared decision-making about firearm storage.Clinical ImplicationsImplementing a decision aid in the clinical setting can improve provider self-efficacy to conduct firearm counseling and help reduce risk factors associated with firearm-related harm among older adults.

Automated summary

Chronic conditions, such as mild cognitive impairment and depression, increase the risk of firearm suicide among older adults. However, firearm counseling is not commonly conducted in clinical settings. This study explores provider perspectives on the resources needed to address firearm safety with older adult patients, using the Ottawa Decision Support Framework.