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Association between patient attitudes towards deprescribing and subsequent prescription changes
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  • Caroline McCarthy,
  • Michelle Flood,
  • Barbara Clyne,
  • Susan Smith,
  • Fiona Boland,
  • Emma Wallace,
  • Frank Moriarty
Caroline McCarthy
RCSI University of Medicine and Health Sciences

Corresponding Author:carolinemccarthy@rcsi.ie

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Michelle Flood
RCSI University of Medicine and Health Sciences
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Barbara Clyne
RCSI University of Medicine and Health Sciences
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Susan Smith
Trinity College Dublin
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Fiona Boland
RCSI University of Medicine and Health Sciences
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Emma Wallace
University College Cork
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Frank Moriarty
RCSI University of Medicine and Health Sciences
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Abstract

Deprescribing is an essential component of safe prescribing, especially for people with higher levels of polypharmacy. Identifying individuals prepared to consider medicine changes may facilitate deprescribing-orientated reviews. We aimed to explore the relationship between revised patient attitudes towards deprescribing (rPATD) scores and medication changes in older people prescribed ≥15 medicines. A secondary analysis of rPATD scores and prescription data from a cluster randomised controlled trial of a GP-delivered, deprescribing-orientated medication review was conducted. The association between number of medicines stopped, started and changed and baseline rPATD scores was assessed using Poisson regression adjusting for patient age, gender, study group allocation, baseline number of medicines and effects of clustering. Participants (n=404) had a mean age of 76.4 years and were prescribed a mean of 17.1 medicines at baseline. Willingness to stop a medicine was associated with higher rates of both deprescribing (IRR: 1.40; 95%CI: 1.06-1.84) and initiating medicines (IRR: 1.43; 95%CI: 1.09-1.88). Satisfaction with current medicines was associated with a lower rate of deprescribing (IRR: 0.69; 95%CI: 0.57-0.85). The rPATD questionnaire could be used as part of a deprescribing intervention to identify participants who may be prepared to engage in deprescribing, enabling more efficient use of clinician time during complex consultations.
16 Jan 2023Submitted to Basic & Clinical Pharmacology & Toxicology
17 Jan 2023Submission Checks Completed
17 Jan 2023Assigned to Editor
17 Jan 2023Review(s) Completed, Editorial Evaluation Pending
18 Jan 2023Reviewer(s) Assigned
16 Feb 2023Editorial Decision: Revise Major
06 Mar 20231st Revision Received
07 Mar 2023Submission Checks Completed
07 Mar 2023Assigned to Editor
07 Mar 2023Review(s) Completed, Editorial Evaluation Pending
08 Mar 2023Reviewer(s) Assigned
09 Mar 2023Editorial Decision: Accept