antiobiotics, pill, in hands

A new survey study sheds light on the attitudes of older adults who disagree with deprescribing recommendations. Nearly half of the people 65 and older who were surveyed said they had doubts about discontinuing prescription medications, according to the report published Wednesday in JAMA Network Open.

Researchers found that older adults who didn’t agree with a hypothetical recommendation to stop taking a prescription medication were more interested in additional communication, alternative strategies or having their medication preferences considered compared with those who strongly disagreed. 

The authors say that understanding the degree in which people disagree could be used to tailor communication about deprescribing for older adults.

Researchers conducted the study between December 2020 and March 2021. The study involved 899 people over 65 in the UK, US, Australia and the Netherlands. The mean age was 71.5, and 50.7% were men. The scientists put them into two different cohorts and explored attitudes about stopping a cholesterol and triglyceride-lowering drug (simvastatin) and a drug to reduce stomach acid (lansoprazole).

Of the participants, 40.2% had doubts about the decision to stop the medication, 15.5% said they valued their medications and 14.7% preferred not to change the medications. It was more common for people who valued their prescriptions to strongly disagree compared to those who disagreed. 

The researchers assessed what may help them agree with the recommendation to stop a medication. Of the participants, 25% said better communication would help, while 15.4% wanted alternatives and 15.2% wanted their preferences considered.  Of those who wanted additional communication, 28.2% were people who disagreed with stopping a medication and 14.2% were those who strongly disagreed; 16.9% who disagreed and 10.2% who strongly disagreed wanted alternative strategies. And 17.6% who disagreed and 7.3% who strongly disagreed wanted their preferences considered.

The authors pointed out in the report that about 80% of older adults say they’re willing to stop a medication if a healthcare professional recommends it, but 42% to 75% of older adults won’t participate in studies to understand their thoughts on deprescribing.