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

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. 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. 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. 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. 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.