New Clinical Investigation: Physician Perspectives on Deprescribing Cardiovascular Medications for Older Adults

Reasons for considering deprescribing cardiovascular medications, by specialty.

Goyal P, Anderson TS, et al. Physician Perspectives on Deprescribing Cardiovascular Medications for Older Adults. J Am Geriatr Soc. 2019; doi: 10.1111/jgs.16157.

A national cross-sectional survey study recently published in the Journal of the American Geriatrics Society examined motivators and barriers to deprescribing cardiovascular medications among physicians of different specialties.  Co-primary authors Dr. Parag Goyal of Weill Cornell Medicine in New York City and Dr. Tim Anderson of Beth Israel Deaconess Medical Center in Boston and colleagues surveyed 750 physicians in 3 specialties: (1) geriatrics; (2) general internal medicine; and (3) cardiology. Reasons for deprescribing varied across medical specialties. While adverse drug reactions were the most common reason for deprescribing in all three specialties, geriatricians were more likely (73%) than general internists (37%) or cardiologists (14%) to consider deprescribing a medication due to limited life expectancy. All three specialties noted similar barriers, including fear of altering other physicians’ treatment plans, patient reluctance, and patient misunderstanding of deprescribing. These findings call for a proactive, patient-centered approach to deprescribing cardiovascular medication that includes increased coordination of care, and communication between physicians and patients. Understanding how to improve physician-physician and physician-patient communication is essential research needed to improve implementation of deprescribing.

Dr. Parag Goyal said, “We hope our study will contribute to advancing deprescribing as a patient-centered strategy that can improve the safety of medication prescribing practice, and improve the wellbeing of older adults.”

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