The following is a summary of “Weighing the necessities and concerns of deprescribing among older ambulatory patients and primary care trainees: a qualitative study,” published in the June 2023 issue of Primary Care by Loon, et al.
Deprescribing medications to older individuals can be complex, particularly for early-career doctors, including primary care trainees. Limited data exist on the perspectives of patients and doctors, especially in developing countries, regarding the deprescribing of medications in older individuals. For a study, researchers sought to explore the needs and concerns associated with deprescribing in older ambulatory patients and primary care trainees.
A qualitative study involved interviews with patients and primary care trainees (referred to as doctors). Patients aged 60 years or older, diagnosed with at least one chronic disease, prescribed five or more medications, and able to communicate in English or Malay were recruited. Doctors and patients were purposefully selected based on their stage of training as family medicine specialists and ethnicity, respectively. All interviews were recorded and transcribed verbatim. A thematic approach was used to analyze the data.
A total of 24 in-depth interviews (IDIs) with patients and four focus group discussions involving 23 doctors were conducted. Four themes emerged from the analysis: understanding the concept of deprescribing, recognizing the need for deprescribing, concerns regarding deprescribing, and factors influencing deprescribing. Patients showed receptiveness to deprescribing when explained to them, while doctors demonstrated a good understanding of it. Both patients and doctors considered deprescribing when the necessity outweighed their concerns. Factors influencing deprescribing included doctor-patient rapport, health literacy among patients, external influences from caregivers and social media, and system-related challenges.
Both patients and doctors recognized the necessity of deprescribing when appropriate. However, both groups feared initiating deprescribing due to concerns of disrupting the established treatment regimen. Early-career doctors felt hesitant to deprescribe medications initiated by other specialists. Doctors expressed a need for more training on deprescribing techniques.