Evidence mapPaperPMID 40425464Full record

ArticleAnnals of family medicine2025

Proactive Deprescribing Among Older Adults With Polypharmacy: Barriers and Enablers.

Kenya Ie, Reiko Machino, Steven M Albert, Shiori Tomita, Hiroki Ohashi, Iori Motohashi, Takuya Otsuki, Yoshiyuki Ohira, Chiaki Okuse

Abstract read
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Article in Annals of family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Kenya IeDepartment of General Internal Medicine, Kawasaki Municipal Tama Hospital, Shukugawara, Tama Ward, Kawasaki, Kanagawa, Japan iekenya0321@gmail.com.
Reiko MachinoDepartment of General Internal Medicine, Kawasaki Municipal Tama Hospital, Shukugawara, Tama Ward, Kawasaki, Kanagawa, Japan.
Steven M AlbertDepartment of Behavioral and Community Health Sciences, University of Pittsburgh, School of Public Health, Pittsburgh, Pennsylvania.
Shiori TomitaTama Family Clinic, Tama Ward, Kawasaki, Kanagawa, Japan.
Hiroki OhashiTama Family Clinic, Tama Ward, Kawasaki, Kanagawa, Japan.
Iori MotohashiDepartment of General Internal Medicine, Kawasaki Municipal Tama Hospital, Shukugawara, Tama Ward, Kawasaki, Kanagawa, Japan.
Takuya OtsukiDepartment of General Internal Medicine, Kawasaki Municipal Tama Hospital, Shukugawara, Tama Ward, Kawasaki, Kanagawa, Japan.
Yoshiyuki OhiraDepartment of General Internal Medicine, St Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
Chiaki OkuseDepartment of General Internal Medicine, Kawasaki Municipal Tama Hospital, Shukugawara, Tama Ward, Kawasaki, Kanagawa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUnderstanding 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.

methodsWe 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.

resultsPlacing 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%).

conclusionsPatients' 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.

Indexed as

DeprescriptionsPolypharmacyAgedAged, 80 and overDecision MakingFemaleHumansInterviews as TopicJapanMalePatient PreferencePhysician-Patient RelationsQualitative Researchagedchronic illnessdecision makingdeprescribingpatient-centered carephysician-patient relationshippolypharmacypotentially inappropriate medicationprimary care

Identifiers

PMID40425464
PMCPMC12120148

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.