Views on Medication Changes Among Nursing Home Residents with a Limited Life Expectancy and Their Relatives: A Qualitative Study

BACKGROUND: Appropriate medication management for nursing home residents with a limited life expectancy may require deprescribing inappropriate medications and prescribing appropriate medications that were previously omitted. Knowledge on views of nursing home residents with a limited life expectancy and their relatives on medication changes, and their preferred involvement in decision-making is limited. OBJECTIVE: To explore (1) views among nursing home residents with a limited life expectancy and their relatives on medication changes, and (2) how they want to be involved in the decision-making process. METHODS: Twenty-three semi-structured interviews were conducted with nursing home residents with a limited life expectancy residing in psychogeriatric and somatic Dutch long-term care units and their relatives. Twelve residents and eleven relatives were included. The interviews were conducted individually and analysed thematically. RESULTS: Nursing home residents and their relatives are generally open to medication changes; however, they are often unaware of this possibility. Their views on medication changes are shaped by the resident's current well-being and the perceived necessity of medication.They generally trust the physician and rely on the physician's initiative and advice. The degree of medication knowledge and preferences regarding decision-making involvement vary widely and depend on several factors. CONCLUSION: Because residents and relatives rely on the physician's initiative, physicians play a pivotal role in empowering them to participate in medication decisions. Proactively inquiring about their medication knowledge and preferences regarding medication use and decision-making may improve appropriate prescribing and shared decision-making.