Association between patient attitudes towards deprescribing and
subsequent prescription changes
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.