Views of key stakeholders on deprescribing preventive medication in people living with dementia: a qualitative systematic review protocol

Clare Bates; Nikolaos Efstathiou; Claire Sutton; Nesrein Hamed; Ian Maidment

doi:10.1136/bmjopen-2024-085812

Views of key stakeholders on deprescribing preventive medication in people living with dementia: a qualitative systematic review protocol

Clare Bates, Nikolaos Efstathiou, Claire Sutton, Nesrein Hamed, Ian Maidment

Aston Pharmacy School

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: As people get older, they tend to take more preventive medication such as statins, beta-blockers and anti-coagulants to help prolong their lives. The risks of taking medication can start to outweigh the benefits in older people, and whether those with comorbidities want to extend these years of poor health is another consideration. One-third of older people will develop dementia, and they may not have the mental capacity to decide whether to continue or withdraw preventive medication. In these cases, deprescribing is left to advocates, such as healthcare professionals and family members. This systematic review will look at the views of stakeholders, including advocates, people living with dementia and any other people involved in the decision-making process for deprescribing preventive medication in dementia.

Methods and analysis: A systematic review of qualitative evidence using thematic synthesis and an inductive approach will be conducted. The following databases and platforms will be searched: Embase, HMIC, MEDLINE, PsycINFO, CINAHL, PubMed, Cochrane Central Library, OATD, ProQuest, Scopus and the Web of Science, along with manual searches through citation mining and grey literature. Only primary qualitative studies (or the qualitative elements of mixed method studies) will be used. There will be no date limit, and the search will be completed by April 2025. Only English-language articles will be used. The included studies will present views and experiences about deprescribing specifically preventive medication in dementia cases. Principles identified by Cochrane for qualitative studies will be used as guidance. Covidence will facilitate two independent reviewers to identify relevant studies, and the Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool will be used to assess quality. NVivo will be used to manage the extracted findings from the included studies.

Original language	English
Article number	e085812
Number of pages	7
Journal	BMJ Open
Volume	15
Issue number	3
Early online date	26 Mar 2025
DOIs	https://doi.org/10.1136/bmjopen-2024-085812
Publication status	Published - 26 Mar 2025

Bibliographical note

Copyright © Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/

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C Bates et al_Views of key stakeholders on deprescribing preventive medication in people living w dementia_qualitative systematic review protocol
Copyright © Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Final published version, 325 KBLicence: CC BY-NC 4.0

Cite this

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abstract = "Introduction: As people get older, they tend to take more preventive medication such as statins, beta-blockers and anti-coagulants to help prolong their lives. The risks of taking medication can start to outweigh the benefits in older people, and whether those with comorbidities want to extend these years of poor health is another consideration. One-third of older people will develop dementia, and they may not have the mental capacity to decide whether to continue or withdraw preventive medication. In these cases, deprescribing is left to advocates, such as healthcare professionals and family members. This systematic review will look at the views of stakeholders, including advocates, people living with dementia and any other people involved in the decision-making process for deprescribing preventive medication in dementia.Methods and analysis: A systematic review of qualitative evidence using thematic synthesis and an inductive approach will be conducted. The following databases and platforms will be searched: Embase, HMIC, MEDLINE, PsycINFO, CINAHL, PubMed, Cochrane Central Library, OATD, ProQuest, Scopus and the Web of Science, along with manual searches through citation mining and grey literature. Only primary qualitative studies (or the qualitative elements of mixed method studies) will be used. There will be no date limit, and the search will be completed by April 2025. Only English-language articles will be used. The included studies will present views and experiences about deprescribing specifically preventive medication in dementia cases. Principles identified by Cochrane for qualitative studies will be used as guidance. Covidence will facilitate two independent reviewers to identify relevant studies, and the Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool will be used to assess quality. NVivo will be used to manage the extracted findings from the included studies.",

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AU - Sutton, Claire

AU - Hamed, Nesrein

AU - Maidment, Ian

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N2 - Introduction: As people get older, they tend to take more preventive medication such as statins, beta-blockers and anti-coagulants to help prolong their lives. The risks of taking medication can start to outweigh the benefits in older people, and whether those with comorbidities want to extend these years of poor health is another consideration. One-third of older people will develop dementia, and they may not have the mental capacity to decide whether to continue or withdraw preventive medication. In these cases, deprescribing is left to advocates, such as healthcare professionals and family members. This systematic review will look at the views of stakeholders, including advocates, people living with dementia and any other people involved in the decision-making process for deprescribing preventive medication in dementia.Methods and analysis: A systematic review of qualitative evidence using thematic synthesis and an inductive approach will be conducted. The following databases and platforms will be searched: Embase, HMIC, MEDLINE, PsycINFO, CINAHL, PubMed, Cochrane Central Library, OATD, ProQuest, Scopus and the Web of Science, along with manual searches through citation mining and grey literature. Only primary qualitative studies (or the qualitative elements of mixed method studies) will be used. There will be no date limit, and the search will be completed by April 2025. Only English-language articles will be used. The included studies will present views and experiences about deprescribing specifically preventive medication in dementia cases. Principles identified by Cochrane for qualitative studies will be used as guidance. Covidence will facilitate two independent reviewers to identify relevant studies, and the Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool will be used to assess quality. NVivo will be used to manage the extracted findings from the included studies.

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Views of key stakeholders on deprescribing preventive medication in people living with dementia: a qualitative systematic review protocol

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