Creating a service system architecture for people living with multiple long-term conditions.

Older adults frequently experience medication-related harm, yet little is known about whether they would accept deprescribing recommendations during an emergency department (ED) visit. In this survey study of 116 adults aged 65 years and older presenting to a single academic ED, a validated questionnaire found that most participants were willing to stop ≥1 medications if recommended by their usual prescriber (91%) and were also receptive to recommendations from an emergency clinician (79%). These findings suggest that patient acceptance may not be a major barrier to emergency department-based deprescribing and support the ED as an important setting to initiate deprescribing conversations and reduce medication-related harm. Adverse drug events (ADEs) continue to place a significant burden on the US health care system, resulting in approximately 450,000 to 550,000 emergency department (ED) visits annually among adults aged ≥65 years. Notably, an estimated 70% of these ADE-related ED visits are considered preventable. One promising strategy to reduce preventable ADEs is deprescribing—the process of intentionally discontinuing medications that may be harmful or no longer beneficial.