Send to

Choose Destination
J Gerontol B Psychol Sci Soc Sci. 2018 Sep 20;73(7):e98-e107. doi: 10.1093/geronb/gbx138.

Decision-Making Preferences and Deprescribing: Perspectives of Older Adults and Companions About Their Medicines.

Author information

Wiser Healthcare, Sydney School of Public Health, The University of Sydney, New South Wales, Australia.
Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, New South Wales, Australia.
Sydney Health Ethics, The University of Sydney, New South Wales, Australia.
Centre for Education and Research on Ageing (CERA), Ageing and Alzheimer's Institute, Concord Hospital, The University of Sydney, New South Wales, Australia.
Faculty of Pharmacy, The University of Sydney, New South Wales, Australia.



Polypharmacy in the older population is increasing-and can be harmful. It can be safe to reduce or carefully cease medicines (deprescribing) but a collaborative approach between patient and doctor is required. This study explores decision-making about polypharmacy with older adults and their companions.


Semi-structured interviews were conducted with 30 older people (aged 75+ years, taking multiple medicines) and 15 companions. Framework analysis was used to identify qualitative themes.


Participants varied considerably in attitudes towards medicines, preferences for involvement in decision-making, and openness to deprescribing. Three types were identified. Type 1 held positive attitudes towards medicines, and preferred to leave decisions to their doctor. Type 2 voiced ambivalent attitudes towards medicines, preferred a proactive role, and were open to deprescribing. Type 3 were frail, perceived they lacked knowledge about medicines, and deferred most decisions to their doctor or companion.


This study provides a novel typology to describe differences between older people who are happy to take multiple medicines, and those who are open to deprescribing. To enable shared decision-making, prescribers need to adapt their communication about polypharmacy based on their patients' attitudes to medicines and preferences for involvement in decisions.


Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center