Table 3.

Language Used by Clinicians to Discuss Medications and Deprescribing with Patients and Caregivers

SubthemeRepresentative Quotation
Explicit mention of life expectancyI probably put it something like this: “Do you know that even if a person does not have any medical issues, dementia by itself can shorten your life expectancy? In your father or mother, the goal is to keep them comfortable. With medications there is risk and what are we trying to achieve?” (primary care provider)
Focus on quality of lifeI broach it as a positive thing for the patient: “We're not harming them in any way [by stopping medicines], but we're trying to give them a better quality of life.” (cardiologist)
Focus on long-term benefits of medication versus short-term harmsSomeone like yourself with a lot of other medical problems, with maybe heart problems, lung problems, memory problems, there probably is not a ton of benefit to us being very aggressive in controlling your diabetes…I can certainly get your blood sugars normal, but the problem is by doing that, I expose you to a lot of risks. (endocrinologist)
Conditional or subjective languageI tell them the side effects of this medicine [bladder antimuscarinic] sometimes are a dry mouth. It might cause a little memory problem. (primary care clinician)
Negative framingThere are all these medications that you could try [for incontinence] but they come with a significant risk of causing confusion. (primary care provider)