Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis

Background Harmful and/or unnecessary medication use in older adults is common. This indicates deprescribing (supervised withdrawal of inappropriate medicines) is not happening as often as it should. This study aimed to synthesize the results of the Patients' Attitudes Towards Deprescribing (PATD) questionnaire (and revised versions). Methods Databases were searched from January 2013 to March 2020. Google Scholar was used for citation searching of the development and validation manuscripts to identify original research using the validated PATD, revised PATD (older adult and caregiver versions), and the version for people with cognitive impairment (rPATDcog). Two authors extracted data independently. A meta-analysis of proportions (random-effects model) was conducted with subgroup meta-analyses for setting and population. The primary outcome was the question: If my doctor said it was possible, I would be willing to stop one or more of my medicines. Secondary outcomes were associations between participant characteristics and primary outcome and other (r)PATD results. Results We included 46 articles describing 40 studies (n = 10,816 participants). The meta-analysis found the proportion of participants who agreed or strongly agreed with this statement was 84% (95% CI 81%-88%) and 80% (95% CI 74%-86%) in patients and caregivers, respectively, with significant heterogeneity (I-2 = 95% and 77%). Conclusion Consumers reported willingness to have a medication deprescribed although results should be interpreted with caution due to heterogeneity. The findings from this study moves toward understanding attitudes toward deprescribing, which could increase the discussion and uptake of deprescribing recommendations in clinical practice.

Automated summary

Harmful and unnecessary medication use in older adults is common, indicating a lack of deprescribing. This study aimed to understand patients' attitudes towards deprescribing through the analysis of the PATD questionnaire and its variations. The findings showed that the majority of participants were willing to stop taking medication, which could potentially increase the adoption of deprescribing recommendations in clinical practice.