Evidence mapPaperPMID 41457417Full record

ArticlePrimary health care research & development2025

Perceptions of deprescribing for patients with limited life expectancy in primary care.

Emma C M van Aken, Maike S van der Waal, Saskia C C M Teunissen, Allegonda G Uyttewaal, Cathelijne Verboeket-Crul, Hanneke Smits-Pelser, Eric C T Geijteman, Matthew P Grant

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Article in Primary health care research & development, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Emma C M van AkenCenter of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practicehttps://ror.org/0575yy874, Utrecht, The Netherlands.ORCID 0009-0005-3234-0223
Maike S van der WaalCenter of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practicehttps://ror.org/0575yy874, Utrecht, The Netherlands.ORCID 0000-0002-8021-3510
Saskia C C M TeunissenCenter of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practicehttps://ror.org/0575yy874, Utrecht, The Netherlands.ORCID 0000-0001-8827-461X
Allegonda G UyttewaalAcademic Hospice Demeter, De Bilt, The Netherlands.
Cathelijne Verboeket-CrulAcademic Hospice Demeter, De Bilt, The Netherlands.
Hanneke Smits-PelserLeidsche Rijn Julius Healthcare Center, Parkwijk, Utrecht, The Netherlands.
Eric C T GeijtemanDepartment of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands.
Matthew P GrantCenter of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practicehttps://ror.org/0575yy874, Utrecht, The Netherlands.ORCID 0000-0002-6878-9197

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe study aims to understand the perceptions of deprescribing in primary care for patients with a limited life expectancy.

backgroundIn the setting of limited life expectancy, medications may become inappropriate when the possible harms of use outweigh the benefits. Whilst the cessation of potentially inappropriate medications is associated with improved patient outcomes, incorporating this process into routine primary care is poorly enacted.

methodsQualitative interview study performed in primary care settings in the Netherlands, including primary care health professionals, patients with limited life expectancy, and their caregivers. Semi-structured interviews were conducted and analysed using inductive thematic analysis.

findingsThree key themes emerged: (1) facilitating well-being, (2) preventing harm, and (3) dealing with uncertainty. A key goal of mediation use is to facilitate well-being, although the perceptions of this effect may not always match the reality due to changed clinical circumstances. The decision to continue or stop medication is influenced by the wish to prevent harm and to what extent participants find ways to deal with the uncertainties facing them.Reluctance to deprescribe medications is often related to uncertainties around ceasing medications, lack of clear clinical guidance, and the evolving situation of advanced illness. Integrating these discussions into routine primary care for patients with chronic and incurable illnesses may assist patients and healthcare professionals to address issues around medication use in a proactive manner and promote advance care planning discussions.

Indexed as

Attitude of Health PersonnelDeprescriptionsLife ExpectancyPrimary Health CareAdultAgedFemaleHumansInappropriate PrescribingInterviews as TopicMaleMiddle AgedNetherlandsQualitative Researchdeprescribingend-of-life careinterview studyperceptionsprimary care

Identifiers

PMID41457417
PMCPMC12780418

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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.