Deprescribing Gaining Momentum

In May, the Society for Post-Acute and Long-Term Care Medicine launched a campaign called “Drive To Deprescribe: Optimizing Medication Use in Post-Acute and Long-Term Care.” Many nursing home or long-term care residents take 15 or more medications regularly – increasing the risk for adverse events. The goal of the campaign is a 25% reduction in unnecessary and/or inappropriate drugs for this patient population.

In line with that effort, a recent survey completed by 835 adults (= 65 years old) gave insight into how seniors view stopping a medication. They were given 7 explanations for stopping medications in 2 situations: chronic use of a sedativehypnotic such as zolpidem, and statin use in a functionally impaired older person on multiple medications. They were asked to choose the explanations that were the most and least preferred.

In the zolpidem scenario, the least liked phrase was “This medicine is unlikely to help you function.” More favored phrases were “stopping the medicine would be a shared decision, and the doctor would make the change gradually and adjust as needed.” In the statin scenario, preferred phrases were focused around using a harmful total number of medicines and benefits not outweighing risks. For both situations, the most preferred phrase to explain deprescribing centered on the risk of side effects. This suggests it is important to link patients’ concerns about side effects to deprescribing recommendations. Deprescribing should not be perceived as withdrawal of care or limiting care based on age.• Green A, et al. JAMA 2021;4:e212633.

In May, the Society for Post-Acute and Long-Term Care Medicine launched a campaign called “Drive To Deprescribe: Optimizing Medication Use in Post-Acute and Long-Term Care.” Many nursing home or long-term care residents take 15 or more medications regularly – increasing the risk for adverse events. The goal of the campaign is a 25% reduction in unnecessary and/or inappropriate drugs for this patient population.

In line with that effort, a recent survey completed by 835 adults (= 65 years old) gave insight into how seniors view stopping a medication. They were given 7 explanations for stopping medications in 2 situations: chronic use of a sedativehypnotic such as zolpidem, and statin use in a functionally impaired older person on multiple medications. They were asked to choose the explanations that were the most and least preferred.

In the zolpidem scenario, the least liked phrase was “This medicine is unlikely to help you function.” More favored phrases were “stopping the medicine would be a shared decision, and the doctor would make the change gradually and adjust as needed.” In the statin scenario, preferred phrases were focused around using a harmful total number of medicines and benefits not outweighing risks. For both situations, the most preferred phrase to explain deprescribing centered on the risk of side effects. This suggests it is important to link patients’ concerns about side effects to deprescribing recommendations. Deprescribing should not be perceived as withdrawal of care or limiting care based on age.• Green A, et al. JAMA 2021;4:e212633.

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