Short summary

Deprescribing of unnecessary medications may be particularly relevant in older peple with limited life expectancy. Little is known about different health care professionals (HCPs), patients, and relatives' perceptions of deprescribing in this particular population. In this study, we qualitatively explore six different groups of HCPs as well as patients and relatives' attitudes towards deprescribing in older patients with limited life expecntacy.

Rationale

Polypharmacy is prevalent among older people. However, there is a substantial lack of evidence for the benefits of many common medications among this population. Further, frail older people may have a limited life expectancy which might be shorter than the known 'time to benefit' for some drugs. Finally, goals of drug treatment in this population may shift from preventing disease and prolonging life to reducing burden of treatment and maintaining quality of life. As such, deprescribing of unnecessary medications may be particularly relevant in older people with limited life expectancy. 

Several qualitative studies have shown that barriers towards deprescribing in older people with limited life expectancy exist among HCPs. However, these studies primarily concern the views of physicians from within primary care. In order to effectively carry out deprescribing in this population, it is important to gain insight into the perspectives of all HCPs whom are frequently involved in the management of these patients' medications. Further, it is important to understand what may hinder the patients and their relatives from engaging in such deprescribing activities. In this study, we qualitatively explore six different groups of HCPs as well as patients and relatives' attitudes towards deprescribing in older patients with limited life expecntacy through focus group interviews (n=6) and individual interviews (n=16), respectively. 

Description of the cohort

Six different groups of HCPs: 1) health care assistants (from primary care), 2) nurses (from primary and secondary care), 3) clinical pharmacists (from secondary care), 4) geriatricians, 5) general practitioners, and 6) clinical pharmacologists. 

Older patients with limited life expectancy recruited from nursing homes within the Region og Southern Denmark. Relatives pointed out by the included patients.

Data and biological material

Six different groups of HCPs as well as patients and relatives' attitudes towards deprescribing in older patients with limited life expectancy. 

Collaborating researchers and departments

Department of Geriatric Medicine, Odense University Hospital

• Associate professor Jepser Ryg, PhD

Research Unit of General Practice, Department of Public Health, University of Southern Denmark

• Professor Jens Søndergaard, PhD

Migrant Health Clinic, Odense University Hospital

• Associate professor Dorthe Nielsen, PhD