Postdoctoral Fellow Brigham and Women's Hospital and Harvard Medical School Boston, United States
Background: An individual may be less willing to continue taking their medications if they are experiencing side effects, a high treatment burden, or if their medication regimen is complex. All of which can influence adherence and may be cause for deprescribing – a process of stopping or reducing inappropriate medications.
Objectives: Our study investigated the association between patients’ willingness to have medications deprescribed and medication adherence.
Methods: The proposed project is a longitudinal sub-study of the ‘Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre’ (OPTICA) trial, a cluster randomized controlled trial, which took place in Swiss primary care settings. Trial participants were patients aged ≥65 years and over, with ≥3 chronic conditions, and ≥5 regular medications recruited from 43 GP practices. At baseline, patients’ willingness to have medications deprescribed was assessed using the ‘revised Patient Attitudes Towards Deprescribing’ (rPATD) questionnaire and its concerns about stopping score. The data on medication adherence was collected at the 12-month follow-up using the A14-scale. First, the demographics and main clinical characteristics of study participants were described. Then multilevel linear regression analyses adjusted for baseline variables were performed. All models were adjusted for the clustering effect at GP level and the group allocation of GPs.
Results: Of the 298 patients for whom data on the rPATD was collected at baseline, 45% were women and the median age was 78 (IQR: 74-83). Participants in the sample generally reported a high level of medication adherence and self-reported willingness to have medications deprescribed. We did not find evidence for a statistically significant association between adherence and patients’ reported willingness to have medications deprescribed as measured with the rPATD questions “If my doctor said it was possible, I would be willing to stop one or more of my regular medicines”, “I would like my doctor to reduce the dose of one or more of my medicines” or the concerns about stopping score.
Conclusions: We did not find evidence for an association between patients’ reported willingness to have medications deprescribed and medication adherence.
