Analysis of patients’ thoughts and background factors influencing attitudes toward Deprescribing: interviews to obtain hints for highly satisfying and valid prescriptions

Abstract

Background: Prescribing with high levels of medical appropriateness and patient satisfaction improves adherence. However, its appropriateness does not always match patient preference. Deprescription is important for ensuring the safety of medication therapy, but is not straightforward. Although successful deprescribing requires knowledge of patients’ thoughts on their prescriptions and factors that influence their acceptance of deprescribing, few comprehensive studies have been conducted on this topic. The aim of this study was to identify factors that influence patients’ attitudes toward deprescribing and obtain hints on how to achieve higher patient satisfaction and prescribing adequacy. Methods: A questionnaire was administered to hospitalized patients and a logistic regression analysis was conducted to examine factors that influence their attitude toward deprescribing. Individual factors affecting patients’ thoughts and wishes regarding prescribing were extracted and analysed in detail. Results: The analysis included 106 patients, of whom 40 (37.7%) wished deprescribing. Logistic regression analysis showed that “Age”, “Wish to reduce the number and types of medications”, “Satisfaction”, “Concerns about side effects”, and “Wish not to have certain medications changed” were factors influencing attitudes toward deprescribing. The results suggested that the factors were influenced by patients’ perceptions and individual patient backgrounds. There was a gap between willingness to reduce medication and to change their medications. Seventy-eight percent of all respondents indicated that they would like to reduce the number and type of pills they take if possible. However, only 44.6% of these patients indicated that they would actually like to change their medication. Conclusions: This study is the only one to comprehensively investigate prescription content, patient background, and patients’ thoughts on factors influencing attitudes toward deprescribing. This study revealed five factors that can influence inclination toward deprescribing. In addition, the results suggest that patients want to be able to feel well with fewer medications if possible. This information may be useful in determining prescriptions that have high validity and patient satisfaction. Further research is needed on the gap between willingness to reduce medications and to change medications.