Attitudes of Lebanese community-dwelling older adults towards deprescribing using the rPATD tool

• Published in: Archives of gerontology and geriatrics 2023-02, Vol.105, p.104840-104840, Article 104840
• Main Authors: Hanna, Venise, Chahine, Bahia, Souheil, Farah Al
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Deprescribing; Elderly; Humans; Independent Living; Lebanon; Polypharmacy; rPATD; Willingness
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2022.104840

•Most Lebanese older adults showed high willingness to deprescribing, especially those on polypharmacy.•Increased concerns about discontinuing a medication were found to be a major barrier to deprescribing.•Increased patient belief that the medications are no longer appropriate proved to be an enabler to deprescribing. To assess the attitude of community-dwelling Lebanese older adults towards deprescribing using the Revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire and to determine patient-related factors that impact their willingness for deprescribing. A cross-sectional face-to-face survey was conducted in Lebanon over the period extending between October 2021 and March 2022 using the validated Arabic version of the rPATD questionnaire. It included ambulatory older adults who were 65 years of age or older, presenting to the community pharmacy, taking at least one chronic medication, and having intact cognition. Of the 400 patients approached 300 (87%) agreed to participate. The mean age of participants was 65 (range 65-85 years) and 148 (56.3%) were females. The mean number of medications taken per patient was 5.8 ± 2.67 (range 1-18) and polypharmacy was reported among 188 patients (71.8%). Nearly all of study subjects 233 (89.0%) were willing to discontinue one or more of their regular medications if their physician said it was possible. The multivariate logistic regression analysis showed that the appropriateness of medications factor (OR= 3.9, 95% CI 1.308, 12.16, p=0.015) and patients’ concern about stopping the medications factor (OR=0.116, 95% CI 0.033, 0.40, p = 0.001) were significantly associated with patients’ willingness to deprescribe. A noteworthy percentage of the Lebanese older outpatients were willing to stop one or more of their regular medications if their doctor recommends so. Patients' belief in appropriateness of medications and concerns about stopping were noted to significantly influence their willingness to deprescribe in this sample population.