Factors associated with patient preferences towards deprescribing: a survey of adult patients on prescribed medications

Abstract

Background Deprescribing is a patient-centered intervention with inherent uncertainties and requires shared decision making and patient involvement. Objective In the present study, we aimed to investigate factors associated with patient preferences toward deprescribing in a representative sample in Japan. Methods We conducted a nationwide cross-sectional survey and used a quota sampling method to select representative samples of the Japanese general population. We collected data on participant demographic and clinical factors including the number of chronic health conditions and the number of regular prescription medications. Patients' willingness to deprescribe was assessed using the patients' attitudes towards deprescribing questionnaire. Multivariable logistic regression analyses were conducted to determine factors associated with the outcome measure. Results Data were analyzed for 1483 adult outpatients. The proportion of patients having willingness to deprescribe was 67.8%. After adjustment for age and gender, multimorbidity was significantly positively associated with patients' willingness to deprescribe [adjusted odds ratio (aOR) 1.35; 95% confidence interval (CI) 1.06–1.72]. A similar association was found with polypharmacy (aOR 1.43; 95% CI 1.08–1.88). The number of visits to medical institutions and increasing age were also found to be associated with patients' willingness to deprescribe. Conclusion Our study indicated that patient preferences towards deprescribing are consistent with the established clinical evidence regarding the efficacy of deprescribing for patients with multimorbidity and polypharmacy. These findings may be beneficial for health care providers to implement shared decision making regarding deprescribing effectively.

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