For older individuals reaching the last years of life, continued use of some medications may be of questionable benefit due a limited life expectancy and shifts in goals of care. In such situations, it may therefore be relevant to reduce or discontinue treatment with these medications. Despite this, a number of barriers towards deprescribing have been identified among both patients, relatives, and health care professionals.

In a series of papers, we explore attitudes towards deprescribing from the perspective of both patients, relatives, and health care professionals. We do this to get a better understanding of what may hinder as well as facilitate deprescribing, as this will help us developing interventions, tools, and strategies that may improve the uptake of deprescribing in clinical practice. We explore patient/relative and prescriber perspectives through both systematic reviews, qualitative studies, and surveys.

Numerous deprescribing interventions have been shown to be feasible, safe, and generally effective at reducing medication use. However, the evidence of impact on patient-important outcomes, such as quality of life, is limited.

With ODIN-1, we will test whether a comprehensive and patient-centered deprescribing intervention can improve quality of life as well as other outcomes among older patients with limited life expectancy. The intervention will be focused on aligning medical treatment with patient’s preferences, and it will be carried out in collaboration between patient and general practitioner.

The trial will be initiated during the summer of 2020 and run for one year. The study is funded by the VELUX Foundation.

A patient’s estimated life expectancy is an essential part of individual care planning in the last part of life. A careful discussion about life expectancy between patients and physicians may assist patients in making informed decisions related to e.g. medication use and deprescribing, screening needs, and personalized care. Several studies have explored patient preferences for discussing life expectancy but the results are conflicting. Further, previous research has primarily focused on the preferences of patients with cancer and to a lesser extent other patient populations where discussions about life expectancy may also be particularly relevant.

In two studies, we explore patient preferences for discussing life expectancy. In the first study, we provide a comprehensive overview of the literature on patient preferences for discussing life expectancy and, in the second study, we examine these preferences in a Danish geriatric outpatient setting.

Admission to nursing home generally indicates an altered disease status, a certain level of frailty, and a relatively limited life expectancy, thus representing a time where treatment goals might change from preventive to symptomatic control. To ensure appropriate medication use among nursing home residents, insight into characteristics of and use of medication among nursing home residents is needed.

In a series of studies, we use the nationwide Danish health registries to examine characteristics of and drug use patterns in the Danish nursing home population.