Barriers and enablers to deprescribing from the perspectives of older adults with polypharmacy and their stakeholders: A systematic review of qualitative studies.
Wenzhong Zhang, Bin Ma, Yuanmin Jia et al.
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In 30 seconds
This systematic review synthesised qualitative studies on barriers and enablers to deprescribing among older adults with polypharmacy and relevant stakeholders. Across 52 studies, the authors identified 18 barriers and 11 enablers, grouped into patient-level, physician–patient relationship and communication, and healthcare professional-level themes. Medication-related experiences and interactions with healthcare professionals shaped older adults’ attitudes toward stopping medicines. Communication and clinician involvement could support deprescribing, while inadequate communication could reinforce continued long-term use. Findings were mapped to nine domains of the Theoretical Domains Framework, most often Social influences, Environmental context and resources, and Beliefs about consequences.
Key findings
- The review included 52 qualitative studies and identified 18 barriers and 11 enablers to deprescribing.
- Findings clustered into patient-level, physician–patient relationship and communication, and healthcare professional-level factors.
- Subthemes mapped to nine of 14 Theoretical Domains Framework domains; Social influences, Environmental context and resources, and Beliefs about consequences were most represented.
Why it matters
Deprescribing involves more than a medication decision: accumulated experiences, communication, and healthcare professional actions can shape whether it is considered and implemented. Recognising these interacting influences may help inform patient-centred, theory-informed approaches that support shared decision-making and safe deprescribing in older adults with polypharmacy.