How do I involve patients and their families in the decision-making process regarding deprescribing?

Involving patients and their families in deprescribing decisions involves several key steps:

• Offer the opportunity for involvement: Invite patients to participate in decisions about their medicines and establish their preferred level of involvement, including whether they want family or carers involved.
• Communicate effectively: Adapt communication to the patient's needs, considering disabilities, language barriers, or cognitive capacity, and use accessible formats or advocates if needed.
• Discuss benefits and risks: Clearly explain the condition, the role of the medicine, and the potential benefits and harms of continuing, adjusting, or stopping the medication at a level the patient understands.
• Use shared decision-making: Explore the patient’s preferences, concerns, and hopes for treatment outcomes, acknowledging any differences in views about risks and benefits.
• Address dependence and withdrawal sensitively: When deprescribing medicines associated with dependence, reassure patients that dependence is an expected effect, discuss withdrawal benefits, and allow time to explore their circumstances and preferences.
• Support family involvement: Ask patients if they want family members or carers to support them during consultations and decision-making.
• Document and provide information: Record discussions, decisions, and any concerns, and provide patients and families with updated management plans and contact information for ongoing support.

These steps help ensure that deprescribing decisions are patient-centred, respectful of autonomy, and supported by clear, empathetic communication involving both patients and their families.

References: NICE CG76,NICE NG215