Reasons why older adults in three countries agreed with a deprescribing recommendation in a hypothetical vignette.

The purpose of this study was to examine factors important to older adults who agreed with a deprescribing recommendation given from a General Practitioner (GP) to a hypothetical patient experiencing polypharmacy. We conducted an online, vignette-based, experimental study in the United Kingdom, United States, and Australia with participants ≥65 years. The primary outcome was agreement with a deprescribing recommendation (6-point Likert scale; 1=strongly disagree and 6=strongly agree). We performed a content analysis of the free text reasons provided by participants who agreed with deprescribing (score of 5 or 6). Among 2,656 participants who agreed with deprescribing, approximately 53.7% shared a preference for following the GP's recommendation or considered the GP the expert. The medication was referred to as a reason for deprescribing by 35.6% of participants. Less common themes included personal experience with the medicine (4.3%) and older age (4.0%). Older adults who agreed with deprescribing in a hypothetical vignette most frequently reported a desire to follow the recommendations given the GP's expertise. Future research should be conducted to help clinicians efficiently identify patients who have a strong desire to follow the doctor's recommendations related to deprescribing as this may allow for a tailored, brief deprescribing conversation.