Patients beliefs and attitudes towards deprescribing: Can deprescribing success be predicted?
BACKGROUND
The ability of questionnaires such as the Patients' Attitudes Towards Deprescribing (PATD) or the Beliefs about Medicines Questionnaire (Specific section) (BMQ-Specific) to successfully identify patients who will deprescribe remains unknown.


OBJECTIVE
To determine if screening questionnaires assessing patients' attitudes and beliefs towards medications and deprescribing can predict deprescribing outcomes.


METHODS
This is a post-hoc secondary analysis of the D-PRESCRIBE trial. 489 community-dwelling adults (≥65 years) who were chronic users (≥3 months) of a potentially inappropriate medication were randomized to a pharmacist-led educational intervention or usual care. Association between baseline responses to PATD and BMQ-Specific items and successful deprescribing was calculated. To determine predictive ability of questionnaire items, receiver operating characteristic curves (ROC) were constructed and area under the curve was calculated.


RESULTS
At baseline, 86% of participants (95% confidence interval [CI] 83-89%) indicated a willingness to deprescribe, yet only 41% (95%CI 37-46%) successfully deprescribed. Six items were associated with deprescribing success, however, no PATD or BMQ-Specific item - either independently or in combination - meaningfully distinguished which participants succeeded or failed deprescribing attempts at 6-months (AUC < 0.7).


CONCLUSION
Current tools to assess patient's attitudes and beliefs towards medication use and/or deprescribing have low predictive validity for successful deprescribing.
['Turner|Justin P|JP|', 'Martin|Philippe|P|', 'Zhang|Yi Zhi|YZ|', 'Tannenbaum|Cara|C|']
D000328:Adult D000368:Aged D001290:Attitude D000069340:Deprescriptions D006801:Humans D008875:Middle Aged D019338:Polypharmacy D000067561:Potentially Inappropriate Medication List D011795:Surveys and Questionnaires
Deprescribe Potentially inappropriate medication Older adults Predictive value Surveys and questionnaires