A quantitative exploration of attitudes towards deprescribing in patients with multimorbidity and polypharmacy in primary care

Objectives

Population ageing has led to an increase in multimorbidity and polypharmacy. Some medications may need to be stopped, but patient attitudes towards deprescribing are poorly understood. This study explores attitudes towards (de) prescribing in patients with multimorbidity in the UK primary care.

Design

Cross-sectional study.

Setting

UK Practice Survey.

Participants

Patients with multimorbidity were invited to complete the Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire using an Evergreen Life’s Personal Health Record App (Manchester, UK). The responses were linked to electronic health records. Anonymised data were analysed in a trusted research environment (University of Liverpool) for group comparisons and using multivariable logistic regression to identify factors associated with satisfaction with current medications.

Results

A total 1,019 patients participated in the study (n = 365 aged <65, 30% males; n = 654 ≥ 65, 57% males). Most patients were satisfied with their current medications (74% aged <65, 70% aged ≥65) but were willing to stop one or more of their regular medicines if their doctor said it was possible (82%, 68% accordingly). Polypharmacy, use of antihypertensive drugs, and antidepressants were associated with patient-reported burden in taking medicines. Frailty did not influence patient deprescribing attitudes. Patients who were satisfied with current medications had fewer medications. Independent predictors of satisfaction with current medications were higher total involvement and appropriateness scores, and lower total burden score.

Conclusions

Most patients with multimorbidity would consider stopping some of their medications, even when they are generally satisfied with the treatments they received. Frailty status does not imply willingness to stop medications. Clinicians should discuss medication deprescribing for shared decision.