Attitudes of older patients and caregivers towards deprescribing of medications in Ethiopia

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Abstract Background: Deprescribing as the part of optimal health care is aimed at reducing the overall impact of polypharmacy on patients and health care services. Understanding how older adults and their caregivers understand deprescribing is crucial to ensuring a holistic approach to deprescribing.Objective: To assess the attitude of older patients and caregivers towards deprescribing of medication at Ambo university referral hospital.Methodology: Institutional based cross-sectional study was conducted using the revised Patient Attitude Towards Deprescribing tool (rPATD). The collected data were processed and analyzed by using a statistical package for social science (SPSS-25) and presented in tables. Backward linear regression and logistic regression was used to determine the degree of association between dependent and independent variables. 95% confidence interval and two sides P-value ≤ 0.05 was utilized for reporting. Result: One hundred fifty six (81.3%) of the respondents (i.e.85% of older and 77.2% of caregivers) agreed to stop one or more of their regular medications if the physician recommends doing so despite 98(51.0%) of them (i.e. 49% of older and 53.3% of caregivers) being satisfied with their/their care recipient’s medications. On the overall aggregate mean score, the respondents had neutral position (2.6-3.59) regarding burden and concerns to stopping medications factor score whereas majority of them disagree (1-2.59) with inappropriateness of the medication they had been received and agreed (3.6-5) with the need for their involvement in medicine decision making. Concerns to stopping medicine scores (AOR=0.440, 95% CI=0.262-0.741, P=0.035) was significantly associated with the willingness to have one or more of their regular medicine(s) deprescribed. Perceived levels of medication inappropriateness (AOR=0.653, 95% CI= 0.456-0.936, P=0.020) were significantly associated with the overall satisfaction with their medicines regimen.Conclusion: Majority of older patients and their caregivers would be willing to have their regular medication stopped if the physicians recommend it. Having higher perceived concerns for stopping the medicines and higher medicine inappropriateness factor score were the two main determinants of willingness to deprescribe and overall satisfaction with their medicine respectively. Healthcare providers should prompt the deprescribing process with older adults and caregivers in their regular clinical practice.

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