Limitations
This descriptive study has a few notable limitations. First, in the absence of consent, we were unable to collect additional demographic or clinical characteristic data beyond our study eligibility criteria for those who declined enrollment. Because this content analysis to determine the reasons for declining participation was not part of our original study aims, our HIPAA waiver for screening purposes was limited to only those data necessary to determine study eligibility as defined by the inclusion and exclusion criteria for the trials. Thus, we were unable to assess demographic data (e.g., age, gender, ethnicity/race) for those who declined participation. Such data would be informative to determine the influence of other patient characteristics on willingness to enroll as well as their reasons for declining enrollment. Additionally, not all those who declined enrollment provided a reason, and this study was not designed to include in-depth qualitative interviews of eligible patients to ascertain all possible reasons for declining enrollment; thus, there could be other factors that influenced eligible patients’ decision beyond those captured in these data. Lastly, we could not conduct comparisons between patients and surrogates because these groups were not consistently differentiated in the absence of consent. Other studies have suggested that surrogates may have different attitudes toward deprescribing relative to patients [