Decision-Making Preferences and Deprescribing: Perspectives of Older Adults and Companions About Their Medicines

J Gerontol B Psychol Sci Soc Sci. 2018 Sep 20;73(7):e98-e107. doi: 10.1093/geronb/gbx138.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Decision Making*
  • Deprescriptions*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Patient Preference / psychology
  • Polypharmacy*
  • Spouses / psychology