Doctor speaking with older couple during COVID-19 pandemic

Earlier this year, researchers found that most nursing home residents are open to a deprescribing plan, particularly if it is proposed by their physician. Now, a new study suggests that how physicians phrase the discussion matters as well.

Turns out, older adults are significantly more likely to reduce or stop unnecessary, potentially harmful or goal-discordant medicines when providers use certain phrases to explain the reasons for it, according to a new survey study of 835 older adults.

For example, when it comes to deprescribing preventive and symptoms-relief medicines, respondents said that they preferred providers to use phrases focusing on the risk of side effects. In addition, for preventive medicines, other preferred phrases included references to using a harmful total number of medicines and benefits not outweighing risks. For symptom-relief medicines, additional preferred phrases included references to working together to slowly reduce the dose and the medicine causing more harm than good.

Explanations focused on the extra effort involved in taking a preventive medication or the lack of functional benefit were least preferred, according to researchers from Johns Hopkins University School of Medicine. 

“Our findings highlight the importance of linking deprescribing to the patient’s medical history or concerns about falls and memory impairment, introducing it in language that conveys the shared nature of the decision, and framing it as a positive step to preserve well-being, not a withdrawal of care based on age or life expectancy,” they wrote.

Results of the study were published in JAMA Network Open.