Attitudes of older adults and their carers towards de‐prescribing: A systematic review

Abstract

Polypharmacy is often referred to as the concurrent use of multiple medications by one individual. 1 With an ageing population and in turn people living with more comorbidities, polypharmacy is increasing in older adults. 1,2 Polypharmacy can be harmful in this population. There are changes in drug absorption, distribution, metabolism and excretion with increasing age mainly as a result of reduction in body weight, renal excretion and liver enzyme function. 3 Altered pharmacokinetics can make older people more susceptible to side effects, and there is increased risk of drug interactions. 3 Polypharmacy can also lead to poor medication adherence, impaired quality of life and potentially inappropriate prescribing whereby the risks of the medication outweigh the benefits. 1,5 It has been

Co‐designing an intervention to improve the process of deprescribing for older people living with frailty in the United Kingdom

“…However, we show that deprescribing itself must be carefully managed to optimize effectiveness and minimize risks. Our pathway outlines a person‐centred, clinician‐facilitated approach to deprescribing consultations in primary care, which is also supported by a recent systematic review 54 . Our study further demonstrates that EBCD can work across multiple general practices as part of a programme of research to develop a person‐centred deprescribing process.…”

Impact of Specialized Clinics on Medications Deprescribing in Older Adults: A Pilot Study in Ambulatory Care Clinics in a Teaching Hospital

“…Several patient-related factors are associated with older adults' willingness to deprescribe medications. These factors include trust in the healthcare provider (physicians or pharmacists), medication side effects, less concern about stopping the medication, the prospect of follow up monitoring, being on chronic medications and the perceived burden of polypharmacy ( Sirois et al, 2017 , Chock et al, 2021 , Crutzen et al, 2021 , Seewoodharry et al, 2022 ). As for healthcare professionals, their acceptance to deprescribe was supportive in this study.…”

Implementation considerations of deprescribing interventions: A scoping review

“…Based on the existing literature, Table 1 summarizes potential barriers and enablers of deprescribing at each of these levels. Patient-level factors that may influence deprescribing include self-efficacy, health literacy and/or decision-making capacity [72][73][74], attitude toward deprescribing [75,76], beliefs and perception about benefits, harms, and necessity of specific medications [44], clinical complexity and changes to goals of care [72], and prior experience with deprescribing and/or fear of negative consequences [72,73,[77][78][79].…”