Reasons why older adults in three countries agreed with a deprescribing recommendation in a hypothetical vignette

Abstract

The purpose of this study was to examine factors important to older adults who agreed with a deprescribing recommendation given by a general practitioner (GP) to a hypothetical patient experiencing polypharmacy. We conducted an online, vignette‐based, experimental study in the United Kingdom, United States and Australia with participants ≥65 years. The primary outcome was an agreement with a deprescribing recommendation (6‐point Likert scale; 1 = strongly disagree and 6 = strongly agree). We performed a content analysis of the free‐text reasons provided by participants who agreed with deprescribing (score of 5 or 6). Among 2656 participants who agreed with deprescribing, approximately 53.7% shared a preference for following the GP's recommendation or considered the GP the expert. The medication was referred to as a reason for deprescribing by 35.6% of participants. Less common themes included personal experience with medicine (4.3%) and older age (4.0%). Older adults who agreed with deprescribing in a hypothetical vignette most frequently reported a desire to follow the recommendations given the GP's expertise. Future research should be conducted to help clinicians efficiently identify patients who have a strong desire to follow the doctor's recommendations related to deprescribing, as this may allow for a tailored, brief deprescribing conversation.

Older adults’ attitudes towards deprescribing and medication changes: a longitudinal sub-study of a cluster randomised controlled trial

“…Other studies using the rPATD have shown substantial differences (30%–73% gap) between these questions with the global question responses always higher8 39–43 suggesting the influence of the doctor should not be underestimated. Similarly, a content analysis including over 2500 participants from Australia, the UK and the USA found that approximately one-half of older adults who agreed with deprescribing in a hypothetical scenario felt that the doctor’s recommendation was an important consideration 44…”

“…Similarly, a content analysis including over 2500 participants from Australia, the UK and the USA found that approximately one-half of older adults who agreed with deprescribing in a hypothetical scenario felt that the doctor’s recommendation was an important consideration. 44 …”

Factors Important to Older Adults Who Disagree With a Deprescribing Recommendation

“…The primary outcome was the attitudes, beliefs, fears, and recommended actions of participants in response to the recommendation of deprescribing. The reasons participants agreed and disagreed were substantially different thematically and conceptually; therefore, a content analysis of the responses of participants who agreed (English text only) was conducted separately …”

Welcome to Basic & Clinical Pharmacology & Toxicology 2024

“…As we embark on the new year, we invite you to explore the wealth of knowledge and exciting content our journal offers. In 2023, we published three Special Collections from focused conferences supported by the Nordic Association for the Publication of Basic and Clinical Pharmacology and Toxicology, including Adhesion G‐Protein‐coupled Receptors, 1–10 Transmembrane Transporter Proteins: Catching Transport in Motion 11–19 and Advancing Deprescribing: Learnings from the first International Conference on Deprescribing 20–31 . The second part of the latter Special Collection will appear in the January 2024 issue.…”