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Reasons Behind Continuity of In-Hospital Deprescribing Post Discharge: A Qualitative Study.
Kate J R Johnstone1, Sarah N Hilmer2, Sarita Y Lo2
1Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Journal of the American Medical Directors Association
|March 27, 2026
Summary
Hospital deprescribing for older adults often continues post-discharge when patients understand the plan and have support. Acceptance by patients and providers facilitates successful medication deprescribing.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacy
- Health Services Research
Background:
- Deprescribing inappropriate polypharmacy in older adults is crucial.
- Hospital initiation of deprescribing may not persist post-discharge.
- Post-discharge actioning of deprescribing recommendations can be inconsistent.
Purpose of the Study:
- To explore factors influencing the continuity of hospital-initiated deprescribing.
- To investigate reasons for actioning deprescribing recommendations post-discharge.
- To understand these issues from the perspectives of older adults, their carers, and healthcare professionals.
Main Methods:
- Qualitative observational study conducted in an Australian tertiary metropolitan hospital.
- Interviews with hospital clinicians before discharge.
- Interviews with patients/carers and surveys of community pharmacists one month post-discharge.
- Inductive and deductive thematic analysis of interview transcripts.
Main Results:
- High continuity of deprescribing decisions (85%) and actioning of recommendations (79%) were observed one month post-discharge.
- Key themes identified across all stakeholder groups were acceptance of deprescribing, comprehension of the plan, and a supportive post-discharge environment.
- Nineteen patients/carers, 19 hospital clinicians, and 13 community pharmacists participated.
Conclusions:
- Stakeholders identified critical factors influencing deprescribing continuity and actioning from hospital to post-discharge settings.
- Findings can inform the co-design of interventions to improve deprescribing outcomes.
- Supporting patients and providers is key to successful medication management post-hospitalization.
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