Older Adults' Perspectives on Deprescribing and Non-Pharmacological Pain Management in the Deep South

Most older adults in the US live with multiple chronic conditions, and over one-third experience chronic pain. Risks associated with polypharmacy have led to growing interest in "deprescribing," or reducing potentially harmful medications, in favor of non-pharmacological pain management. This qualitative study explored the views toward deprescribing among community-dwelling older adults (aged 65+) in Alabama with chronic pain, multimorbidity, and polypharmacy. Thirty-four participants completed in-depth telephone interviews. Thematic analysis identified facilitators to deprescribing: interest in holistic care, concerns about long-term side effects, and a desire for better quality of life; barriers: fear of worsening pain, reluctance to change established regimens, and limited provider support; and needs for credible information and social support. Findings highlight the role of education, provider engagement, and access to resources in supporting informed decisions. Tailoring these strategies to underserved settings such as the Deep South may reduce medication-related harms and improve pain management for older adults.