Patients’ willingness to have medications deprescribed in Europe: Protocol for a cross-sectional survey study

Renata Lüthold, Katharina Tabea Jungo, Kristie Weir, Zsófia Rozsnyai, Sven Streit

Keywords: Primary care, Survey, observational study, deprescribing, medication use

Background:

Polypharmacy has been associated with several health-related problems in older adults. To reduce inappropriate polypharmacy, deprescribing should be part of patients’ care. Understanding patients’ views and preferences in deprescribing at individual and country level may help health professionals to find effective ways to involve older adults when implementing deprescribing in primary care.

Research questions:

To investigate older adults' views and preferences on deprescribing in multiple countries and what role patient-GP relationship plays in deprescribing decisions.

Method:

This cross-sectional study is conducted in primary care settings in nine European countries. Eleven National Coordinator members of the EGPRN recruit 10 GPs per county, who recruit 10 patients each (total: 100 patients/site). Patients are included if they are ≥65 years and have polypharmacy (≥5 regular medications). Patients will fill in an online or paper-based survey containing questions on sociodemographic characteristics, willingness to have medications deprescribed (assessed by Revised Patients' Attitudes Towards Deprescribing - rPATD), and patient-GP relationships (Wake Forest Physician Trust Scale). Patients are also asked about which specific medications they would hypothetically like to discontinue. To assess patients’ willingness to have medications deprescribed across countries, we will compare the proportions of self-reported willingness to deprescribe and means of medicines number they would like to stop or reduce. We will report which medications were the most frequently considered for deprescribing and compare them across countries. To investigate the association between trust in physician and patients’ willingness to deprescribe we will use multilevel mixed-effect ordered logistic regression models. Data collection began in May 2022.

Results:

Preliminary findings will be available at the conference.

Conclusions:

Investigating the role of patient-GP relationship in deprescribing and assessing which specific medications patients would rather stop or reduce will help health professionals and researchers to design and implement deprescribing interventions that consider patients’ preferences.

Points for discussion:

How can we facilitate the recruitment of GPs and patients in research?

Which form of questionnaire is more efficient for enhancing response rate, on paper or online?

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