4.3 Article

Patients' attitudes toward deprescribing and their experiences communicating with clinicians and pharmacists

Journal

THERAPEUTIC ADVANCES IN DRUG SAFETY
Volume 13, Issue -, Pages -

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/20420986221116465

Keywords

communication; deprescribing; inappropriate medications; patient; polypharmacy

Funding

  1. Igniting Research Collaborations Grant (University of Kentucky)
  2. NIH National Center for Advancing Translational Sciences [UL1TR001998]
  3. National Institute of Aging [R01AG054130]

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The study aimed to assess patients' beliefs and attitudes towards deprescribing and identify facilitators and barriers to deprescribing. The findings showed that adults taking multiple medications expressed a high willingness to accept deprescribing if their doctor gave permission. Targeted strategies that consider patient characteristics, such as age and education level, may be necessary for successful communication between patients, primary care clinicians, and pharmacists.
Purpose: Developing effective deprescribing interventions relies on understanding attitudes, beliefs, and communication challenges of those involved in the deprescribing decision-making process, including the patient, the primary care clinician, and the pharmacist. The objective of this study was to assess patients' beliefs and attitudes and identify facilitators of and barriers to deprescribing. Methods: As part of a larger study, we recruited patients >= 18 years of age taking >= 3 chronic medications. Participants were recruited from retail pharmacies associated with the University of Kentucky HealthCare system. They completed an electronic survey that included demographic information, questions about communication with their primary care clinician and pharmacists, and the revised Patients' Attitudes Toward Deprescribing (rPATD) questionnaire. Results: Our analyses included 103 participants (n = 65 identified as female and n = 74 as White/Caucasian) with a mean age of 50.4 years [standard deviation (SD) = 15.5]. Participants reported taking an average of 8.4 daily medications (SD = 6.1). Most participants reported effective communication with clinicians and pharmacists (66.9%) and expressed willingness to stop one of their medications if their clinician said it was possible (83.5%). Predictors of willingness to accept deprescribing were older age [odds ratio (OR) = 2.99, 95% confidence interval (CI) = 1.45-6.2], college/graduate degree (OR = 55.25, 95% CI = 5.74-531.4), perceiving medications as less appropriate (OR = 8.99, 95% CI = 1.1-73.62), and perceived effectiveness of communication with the clinician or pharmacist (OR = 4.56, 95% CI = 0.85-24.35). Conclusion: Adults taking >= 3 chronic medications expressed high willingness to accept deprescribing of medications when their doctor said it was possible. Targeted strategies to facilitate communication within the patient-primary care clinician-pharmacist triad that consider patient characteristics such as age and education level may be necessary ingredients for developing successful deprescribing interventions.

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