Table 4

Contexts associated with negative outcomes

Key theme Successful deprescribing (n=7) Failed deprescribing (n=7) No attempt to deprescribe
Supporting citation
Previous discouragement from physician1 (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 status01 (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 physician1 (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 risk1 (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 function1 (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 life02 (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 physician1 (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 effects05 (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)04 (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)