Ariel R. Green|Hélène E Aschmann|Cynthia M. Boyd|Nancy L. Schoenborn
Assessment of Patient-Preferred Language to Achieve Goal-Aligned Deprescribing in Older Adults
Johns Hopkins Medicine|Johns Hopkins University|University of Zurich|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University
h3importanceh3 clinicians communicate deprescribing structured process reducing stopping unnecessary potentially harmful goaldiscordant medicines may associated extent older adults willing h3objectiveh3 examine older adults preferences regarding different rationales clinician may use explain patient stop unnecessary potentially harmful medication h3design setting participantsh3 crosssectional survey study conducted march 25 april 19 2020 among nationally representative probabilitybased online survey panel knowledgepanel knowledgepanel members aged 65 years older recruited random digit dialing addressbased sampling data analyzed may 4 july 8 2020 h3exposuresh3 survey presented 2 vignettes involving hypothetical older adults one described statin used primary prevention person functional impairment polypharmacy second described sedativehypnotic zolpidem used insomnia person good functional status h3main outcomes measuresh3 vignette participants expressed preferences using bestworst scaling method 7 different phrases clinician may use explain reduce stop medication conditional logistic regression used quantify respondents relative preferences h3resultsh3 total 1193 knowledgepanel members invited 835 respondents 700 completed survey mean sd age 73 6 years 414 496 women 671 804 selfidentified white individuals total 496 respondents 598 ever used statin 124 respondents 149 ever used sedativehypnotic medications preferred phrase explain deprescribing focused risk side effects statins phrase 58fold 95 ci 5363 preferred least preferred option focused effort treatment burden involved taking medicine sedativehypnotics phrase side effects 86fold 95 ci 7995 preferred least preferred option medicine unlikely help function better h3conclusions relevanceh3 findings suggest among older adults preferred rationale deprescribing preventive symptomrelief medicines focused risk side effects results could used inform clinical practice improve effective communications around deprescribing older adults