Wade Thompson1,2, Ida Theemann Jacobsen3, Dorte Ejg Jarbøl4, Peter Haastrup4, Jesper Bo Nielsen4, Carina Lundby3,5,6. 1. Research Unit of General Practice, University of Southern Denmark, Odense, Denmark. wthomp01@gmail.com. 2. Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark. wthomp01@gmail.com. 3. Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark. 4. Research Unit of General Practice, University of Southern Denmark, Odense, Denmark. 5. OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark. 6. Research Unit of Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense, Denmark.
Abstract
BACKGROUND: Deprescribing of preventive medications may be considered in some nursing home residents. It is important to understand how to effectively communicate around this complex decision, from both a physician and resident perspective. OBJECTIVE: The objective of this study was to explore how nursing home residents would like to discuss deprescribing of preventive medications with their physicians. METHODS: We conducted a qualitative study with face-to-face, semi-structured interviews. Participants were Danish nursing home residents aged ≥70 years deemed cognitively able to participate by nursing staff. They were taking one or more of statins, antihypertensives, antihyperglycemics, or antiplatelets. Interviews were audio recorded and transcribed verbatim. Analysis was conducted based on systematic text condensation. RESULTS: Nine nursing home residents (median age 85 years, seven female) were interviewed. Participants were generally aware of their overall number of medications but unaware of specific medications and why they were taking them. All participants displayed a high degree of trust in their physicians, preferring to defer decisions to them, and generally believed their medication was necessary if their physician had prescribed it. Residents would be open to deprescribing if their physician suggested it but were not aware of the possibility to be involved in the decision (e.g., discuss goals of care and treatment preferences) and had difficulty imagining what they could discuss with their physician about a deprescribing decision. CONCLUSION: The interviewed nursing home residents could not imagine how they might discuss potential deprescribing of preventive medications with their physician, and what topics would be important. Future work should explore how nursing home residents can be encouraged to be part of such discussions and investigate ways to have residents share their goals and preferences regarding deprescribing.
BACKGROUND: Deprescribing of preventive medications may be considered in some nursing home residents. It is important to understand how to effectively communicate around this complex decision, from both a physician and resident perspective. OBJECTIVE: The objective of this study was to explore how nursing home residents would like to discuss deprescribing of preventive medications with their physicians. METHODS: We conducted a qualitative study with face-to-face, semi-structured interviews. Participants were Danish nursing home residents aged ≥70 years deemed cognitively able to participate by nursing staff. They were taking one or more of statins, antihypertensives, antihyperglycemics, or antiplatelets. Interviews were audio recorded and transcribed verbatim. Analysis was conducted based on systematic text condensation. RESULTS: Nine nursing home residents (median age 85 years, seven female) were interviewed. Participants were generally aware of their overall number of medications but unaware of specific medications and why they were taking them. All participants displayed a high degree of trust in their physicians, preferring to defer decisions to them, and generally believed their medication was necessary if their physician had prescribed it. Residents would be open to deprescribing if their physician suggested it but were not aware of the possibility to be involved in the decision (e.g., discuss goals of care and treatment preferences) and had difficulty imagining what they could discuss with their physician about a deprescribing decision. CONCLUSION: The interviewed nursing home residents could not imagine how they might discuss potential deprescribing of preventive medications with their physician, and what topics would be important. Future work should explore how nursing home residents can be encouraged to be part of such discussions and investigate ways to have residents share their goals and preferences regarding deprescribing.
Authors: Mette Reilev; Carina Lundby; John Jensen; Søren Post Larsen; Helene Hoffmann; Anton Pottegård Journal: Age Ageing Date: 2019-12-01 Impact factor: 10.668
Authors: Ashok Krishnaswami; Michael A Steinman; Parag Goyal; Andrew R Zullo; Timothy S Anderson; Kim K Birtcher; Sarah J Goodlin; Mathew S Maurer; Karen P Alexander; Michael W Rich; Jennifer Tjia Journal: J Am Coll Cardiol Date: 2019-05-28 Impact factor: 24.094
Authors: Mona J Kalogianis; Barbara C Wimmer; Justin P Turner; Edwin C K Tan; Tina Emery; Leonie Robson; Emily Reeve; Sarah N Hilmer; J Simon Bell Journal: Res Social Adm Pharm Date: 2015-12-19
Authors: Emily Reeve; Jennifer L Wolff; Maureen Skehan; Elizabeth A Bayliss; Sarah N Hilmer; Cynthia M Boyd Journal: JAMA Intern Med Date: 2018-12-01 Impact factor: 21.873
Authors: Amanda Sandbæk; Marlene Christina Rosengaard Møller; Flemming Bro; Kirsten Høj; Line Due Christensen; Anna Mygind Journal: BMC Prim Care Date: 2022-05-20