Title

Decision-making preferences and deprescribing: perspectives of older adults and companions about their medicines

RIS ID

125463

Publication Details

Weir, K., Nickel, B., Naganathan, V., Bonner, C., McCaffery, K., Carter, S. M., McLachlan, A. & Jansen, J. (2018). Decision-making preferences and deprescribing: perspectives of older adults and companions about their medicines. Journals of Gerontology. Series B: Psychological Sciences & Social Sciences, 73 (7), e98-e107.

Abstract

Objectives Polypharmacy in the older population is increasing-and can be harmful. It can be safe to reduce or carefully cease medicines (deprescribing) but a collaborative approach between patient and doctor is required. This study explores decision-making about polypharmacy with older adults and their companions. Method Semi-structured interviews were conducted with 30 older people (aged 75+ years, taking multiple medicines) and 15 companions. Framework analysis was used to identify qualitative themes. Results Participants varied considerably in attitudes towards medicines, preferences for involvement in decision-making, and openness to deprescribing. Three types were identified. Type 1 held positive attitudes towards medicines, and preferred to leave decisions to their doctor. Type 2 voiced ambivalent attitudes towards medicines, preferred a proactive role, and were open to deprescribing. Type 3 were frail, perceived they lacked knowledge about medicines, and deferred most decisions to their doctor or companion. Discussion This study provides a novel typology to describe differences between older people who are happy to take multiple medicines, and those who are open to deprescribing. To enable shared decision-making, prescribers need to adapt their communication about polypharmacy based on their patients' attitudes to medicines and preferences for involvement in decisions.

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Link to publisher version (DOI)

http://dx.doi.org/10.1093/geronb/gbx138