Attitudes Toward Deprescribing Among Older Adults Seeking Care in the Emergency Department
In brief
About 79% of older ED patients would accept deprescribing
In a survey of 116 adults 65 and older presenting to a single academic emergency department, 79% said they would be willing to stop medications if an ED clinician recommended it, and 91% would follow their regular prescriber's advice. Patients also wanted involvement in decisions, suggesting shared-decision deprescribing is feasible, though implementation and outpatient coordination remain to be tested.
- Journal
- Journal of the American College of Emergency Physicians open (Q1)
- Published
- 28 July 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Emma Lopes, Grace Burud, Smeet Bhimani, Parag Goyal, Joshua Niznik, Kaitlin Donovan, et al.
- PMID
- 42569218
- DOI
- 10.1016/j.acepjo.2026.100467
Why clinicians should know about it
- Picked for Internal Medicine (paper of the day, 13 August 2026): Older adults' attitudes toward deprescribing in ED
Abstract
OBJECTIVES: Deprescribing potentially unnecessary or harmful medications may help reduce avoidable emergency department (ED) visits for adverse drug events, which are prevalent among older adults. However, deprescribing in the ED remains rare, in part due to limited evidence on how to implement such practices and an incomplete understanding of patient attitudes in this setting. This study aimed to assess attitudes toward deprescribing among older adults presenting to the ED and explore willingness to accept deprescribing recommendations from emergency clinicians. METHODS: We conducted an observational study of adults aged ≥65 years at a single academic ED from June to October 2024. Participants completed the Revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire, which evaluates general willingness to deprescribe and perceived barriers across four domains: medication burden, perceived appropriateness, concerns about stopping, and involvement in decision making. An exploratory question assessed willingness to deprescribe if recommended by ED staff during an ED visit. Descriptive statistics and 95% CIs were calculated. RESULTS: We enrolled 116 older adults presenting to the ED who completed the rPATD questionnaire. Median patient age was 75 years (IQR 69-80), 72% had multimorbidity, and 56% reported polypharmacy (≥5 medications). Most participants expressed willingness to deprescribe if recommended by their prescriber (91%; 95% CI: 84-95). In contrast, 53% (95% CI: 43-62) expressed reluctance to stop long-standing medications. Most participants reported satisfaction with current medications (87%; 95% CI: 80-92) and a low perceived medication burden, although 28% (95% CI: 21-37) acknowledged possible side effects. Additionally, 87% (95% CI: 80-92%) expressed a desire to be involved in medication-related decisions. Lastly, in an ED-specific exploratory item, 79% of participants (95% CI: 71-86) expressed willingness to deprescribe when recommended by ED staff. CONCLUSION: Older adults presenting to the ED are highly receptive to deprescribing, including when recommended by ED staff. These findings support the feasibility of ED-based deprescribing interventions, particularly those that incorporate shared decision making and coordination with outpatient care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.