Deprescribing in the context of limited life expectancy

  • Research type

    Research Study

  • Full title

    Clinicians’, patients’ and carers’ perspectives on an individualised approach to deprescribing of long-term preventative medicines in people with limited life expectancy

  • IRAS ID

    328120

  • Contact name

    Deborah McCahon

  • Contact email

    deborah.mccahon@bristol.ac.uk

  • Sponsor organisation

    University of Bristol

  • Duration of Study in the UK

    1 years, 5 months, 31 days

  • Research summary

    Many medicines have long-term benefits and prevent illness. However, in the last few weeks of a person’s life, when it is clear they will die soon, medicines are often stopped. Over the last year or two of life, the benefit of continuing to take long-term medicines maybe small and no longer helpful. Stopping medicines at this stage might improve quality of life, reduce side effects and treatment burden. To do this sensitively and effectively, there is a need to find out what information would help doctors and patients to make decisions to stop medicines. Also, it would be helpful to know more about how and when doctors and patients would prefer to have conversations about stopping long-term medicines in the context of limited life expectancy (the last 1-2 years of life).

    The overall aim of this study is to provide evidence and resources for use in primary care to support the acceptable reduction of long-term medicines in patients with limited life expectancy for whom the benefits may not be fully realised.

    Firstly, we will interview 20 patients aged ≥65 years, taking ≥2 long-term medicines, 10-15 carers, and up to 15 GPs and pharmacists. We will ask them if they think it is acceptable to talk about life expectancy and the risks/benefits of long-term medicines when talking about stopping these medicines. We will seek their views on what information would be most helpful to support shared decision making for stopping medicines and when and how such conversations should happen.

    Secondly, we will hold meetings with an expert working group (including patients, carers, professionals) to review findings from the interviews. The group will develop resources for use in clinical practice to help doctors and patients make decisions about stopping long-term medicines that may no longer be of benefit to the patient.

  • REC name

    South West - Cornwall & Plymouth Research Ethics Committee

  • REC reference

    23/SW/0110

  • Date of REC Opinion

    26 Oct 2023

  • REC opinion

    Further Information Favourable Opinion