Deprescribing bisphosphonates for older adults with dementia: perspectives of caregivers
Authors' conclusion
Conversations grounded in caregiver experiences and "what matters most" may help optimize fracture prevention treatment for older adults with dementia.
Study context
- Population
- Family or informal caregivers of older adults living with dementia in the community or in long-term care who had been treated with bisphosphonates
- Participants
- 11 interviews
- Outcome
- Factors influencing caregiver decision-making on continuing vs deprescribing bisphosphonates
Methodological detailsqualitative framework methodology, guided by the Health Belief Model
- Qualitative framework methodology
- Guided by the Health Belief Model
Main finding
As reported in the abstract
- Attempts to maintain functional independence despite high likelihood of falls frequently discussed as contributing to fracture risk
- Many caregivers perceived fracture prevention treatment as important; several noted it may become less important near the end of life
- Perceived benefits of fracture prevention treatment: improved quality of life and maintaining independence
- Possible reasons for deprescribing: gastrointestinal adverse effects, preference for fewer treatments, dementia-related behaviors interfering with medication administration
Further findings
Caregiver characteristics
- Male
- 8
- Younger than 65
- 8
- Adult child caregiver
- 8
- Black
- 3
- Latino/a
- 5
Safety
Tolerability of bisphosphonates (caregiver-reported)
- Most indicated bisphosphonates were well tolerated; gastrointestinal adverse effects may be a reason for deprescribing
Original publication
Deprescribing bisphosphonates for older adults with dementia: perspectives of caregivers. Osteoporos Int. Published 18 November 2023. doi:10.
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