PT  - JOURNAL ARTICLE
AU  - Ie, Kenya
AU  - Machino, Reiko
AU  - Albert, Steven M.
AU  - Tomita, Shiori
AU  - Ohashi, Hiroki
AU  - Motohashi, Iori
AU  - Otsuki, Takuya
AU  - Ohira, Yoshiyuki
AU  - Okuse, Chiaki
TI  - Proactive Deprescribing Among Older Adults With Polypharmacy: Barriers and Enablers
AID  - 10.1370/afm.240363
DP  - 2025 May 01
TA  - The Annals of Family Medicine
PG  - 207--213
VI  - 23
IP  - 3
4099  - http://www.annfammed.org/content/23/3/207.short
4100  - http://www.annfammed.org/content/23/3/207.full
SO  - Ann Fam Med2025 May 01; 23
AB  - PURPOSE Understanding patients’ perspectives and readiness regarding deprescribing—a concept broader than mere drug cessation, encompassing dynamic interaction between patients and health care professionals—is essential for developing feasible and effective deprescribing interventions. The goal of our study was to qualitatively explore the perspectives of older adults regarding proactive deprescribing, as well as its barriers and enablers.METHODS We conducted semistructured interviews with 20 patients in Japan aged 65 years or older who were receiving 5 or more regular medications to explore their perceptions and experiences related to deprescribing. The interviews were transcribed and the data were thematically analyzed to identify major concepts.RESULTS Placing a low value on medication was an important trigger of patients’ proactive attitudes toward deprescribing. Patients were open to deprescribing conversations if they trusted the prescriber. Conversely, patients who had a positive perspective on medication or considered themselves incapable of participating in decision making preferred to defer to a physician. On the basis of medication valuation, decision-making preferences, and openness to deprescribing, we developed a new typology with 5 types of patients: indifferent (15% of study patients), satisfied and risk-averse (10%), compliant (30%), fearful but passive (20%), and proactive (25%).CONCLUSIONS Patients’ attitudes toward deprescribing varied considerably according to their medication valuation, preference for involvement in decision making, and openness to deprescribing. Focusing on patients’ proactiveness and understanding these barriers and enablers is essential for patient-centered decision making and for developing strategies to optimize the appropriateness of medication.