{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:59:09Z","timestamp":1792432749757,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG053264"],"award-info":[{"award-number":["R01AG053264"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Effective deprescribing requires shared decision making between a patient and their clinician, and should be used when implementing evidence-based deprescribing conversations. As part of the Shed-MEDS clinical trial, this study assessed barriers and enablers that influence patient decision making in deprescribing to inform future implementation efforts and adaptations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research Design and Methods<\/jats:title><jats:p>Shed-MEDS, a randomized controlled deprescribing trial, included hospitalized older adults discharging to post-acute care facilities. A trained clinician reviewed each participant\u2019s medical history and medication list to identify medications with potential for deprescribing. The study clinician then conducted a semistructured patient-centered deprescribing interview to determine patient (or surrogate) concerns about medications and willingness to deprescribe. Reeve et al.\u2019s (2013) framework was used to categorize barriers and enablers to deprescribing from the patient\u2019s perspective, including \u201cappropriateness of cessation,\u201d \u201cfear,\u201d \u201cdislike of a medication,\u201d \u201cinfluences,\u201d and \u201cprocess of cessation.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, participants\/surrogates (N = 177) agreed with 63% (883 total medications) of the study clinician\u2019s deprescribing recommendations. Thematic analysis revealed that \u201cappropriateness\u201d of a medication was the most common barrier (88.2%) and enabler (67.3%) to deprescribing. Other deprescribing enablers were in the following domains: \u201cinfluences\u201d (22.7%), \u201cprocess\u201d (22.5%), \u201cpragmatic\u201d (19.4%), and \u201cdislike\u201d (5.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Implications<\/jats:title><jats:p>Use of a semistructured deprescribing interview conversation tool allowed study clinicians to elicit individual barriers and enablers to deprescribing from the patient\u2019s perspective. Participants in this study expressed more agreement than disagreement with study clinicians\u2019 deprescribing recommendations. These results should inform future implementation efforts that incorporate a patient-centered framework during deprescribing conversations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trials Registration Number<\/jats:title><jats:p>NCT02979353<\/jats:p><\/jats:sec>","DOI":"10.1093\/geront\/gnac100","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T16:50:51Z","timestamp":1658854251000},"page":"523-533","source":"Crossref","is-referenced-by-count":22,"title":["Patient-Reported Barriers and Enablers to Deprescribing Recommendations During a Clinical Trial (Shed-MEDS)"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8937-8637","authenticated-orcid":false,"given":"Jennifer L","family":"Kim","sequence":"first","affiliation":[{"name":"Center for Quality Aging, Vanderbilt University Medical Center , Nashville, Tennessee , USA"},{"name":"School of Nursing, Vanderbilt University , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanah M","family":"Lewallen","sequence":"additional","affiliation":[{"name":"Center for Quality Aging, Vanderbilt University Medical Center , Nashville, Tennessee , USA"},{"name":"School of Nursing, Vanderbilt University , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-8840","authenticated-orcid":false,"given":"Emily K","family":"Hollingsworth","sequence":"additional","affiliation":[{"name":"Center for Quality Aging, Vanderbilt University Medical Center , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-059X","authenticated-orcid":false,"given":"Avantika S","family":"Shah","sequence":"additional","affiliation":[{"name":"Center for Quality Aging, Vanderbilt University Medical Center , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra F","family":"Simmons","sequence":"additional","affiliation":[{"name":"Center for Quality Aging, Vanderbilt University Medical Center , Nashville, Tennessee , USA"},{"name":"Geriatric Research, Education, & Clinical Center (GRECC), VA Tennessee Healthcare System , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-5321","authenticated-orcid":false,"given":"Eduard E","family":"Vasilevskis","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education, & Clinical Center (GRECC), VA Tennessee Healthcare System , Nashville, Tennessee , USA"},{"name":"Section of Hospital Medicine, Division of General Internal Medicine & Public Health, Vanderbilt University Medical Center , Nashville, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,26]]},"reference":[{"issue":"Suppl. 1","key":"2023032106164032800_","doi-asserted-by":"crossref","first-page":"S152","DOI":"10.2337\/dc20-S012","article-title":"12. 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