Contexts associated with negative outcomes
| Key theme | Successful deprescribing (n=7) | Failed deprescribing (n=7) |
No attempt to deprescribe (n=7) | Supporting citation |
| Previous discouragement from physician | 1 (14%) | 1 (14%) | 5 (71%) | ‘I asked him (my doctor), ‘Are there any of my medications I could stop?’ He told me, ‘No, we’re not taking anything away, you are doing well’. I then told him my medication was getting very expensive to which he replied, ‘You know Mr., life is priceless’. (75-year-old man, no intent to taper) |
| Poor health status | 0 | 1 (14%) | 4 (57%) | ‘If anyone stops my pills, poof, I would die for sure because of my poor health’. (70-year-old woman, no intent to taper) |
| Unquestioning belief in their physician | 1 (14%) | 1 (14%) | 3 (43%) | ‘If you take all your pills as prescribed, you’ll never have problems in your life […] When my doctor prescribes something for me, I know it’s not junk, I know it’s good for me. And I don’t question it’. (72-year-old man, no intent to taper) |
| Lack of perception of personal risk | 1 (14%) | 2 (29%) | 5 (71%) | ‘I recall that he (my doctor) told me that in the long-term my benzodiazepine could affect my memory. But my memory is fantastic’. (72-year-old man, no intent to taper) |
| Reliance on medication for coping/everyday function | 1 (14%) | 1 (14%) | 4 (57%) | ‘Without this medication, I know that my life would be plagued by anxiety, of this I am certain’. (68-year-old woman, no intent to taper) |
| Quality of life focus during end of life | 0 | 2 (29%) | 3 (43%) | ‘At my age I don’t care about the risks. I don’t care if I live to 100 or not’. (85-year-old woman, failed tapering) |
| Discouragement from a physician | 1 (14%) | 3 (43%) | 5 (71%) | ‘My doctor told me: ‘At your age, don’t worry about it. You’ve been taking this pill for a while and you are fine. You aren’t taking a dangerous dose at all’. (85-year-old woman, failed tapering) |
| Intolerance to recurrence of symptoms/withdrawal effects | 0 | 5 (71%) | _ | ‘When I decreased the dose I started getting headaches. I felt miserable not being able to sleep at night’. (85-year-old man, failed tapering) |
| Loss of confidence to complete the tapering process (postintervention) | 0 | 4 (57%) | 4 (57%) | ‘I knew that I’d be in trouble without my pills. It’s been a long time now. How can I put it in words? If I ran out of pills I’d be in trouble’. (85-year-old man, failed tapering) |