To help elucidate these factors, researchers at the University of Kentucky HealthCare System conducted a study to assess patients' beliefs and attitudes and to identify facilitators of and barriers to deprescribing in the community pharmacy setting. The study was a substudy of a larger trial that looked at primary care clinician and pharmacist perspectives of deprescribing. That study had found that communication barriers with other healthcare providers and insufficient time with patients were obstacles to deprescribing.

Study patients were enrolled in this convenience sample survey in November 2019. To be eligible for inclusion in this survey, patients had to be aged 18 years or older, had to be taking three or more chronic medications (i.e., prescription medications, OTC medications, vitamins, and supplements), and had to speak English.

The survey was administered via iPads at the retail pharmacies associated with the University of Kentucky HealthCare system. The survey took approximately 10 minutes, and patients received a $10 gift card for their participation. It measured patients' beliefs, attitudes, and experiences with deprescribing as well as their level of communication with healthcare providers, including pharmacists. Patients' attitudes toward deprescribing were assessed using the revised Patients' Attitudes Toward Deprescribing (rPATD) questionnaire. rPATD has 22 statements and measures overall satisfaction with medication use and willingness to accept deprescribing recommendations.

In addition, 20 questions were grouped into four factors: burden factor (which pertained to perceived medication burden), appropriateness factor (which referred to attitudes toward the appropriateness of a patient's medication regimen), concerns about stopping factor, and involvement factor (which pertained to how much patients knew about their medications and how engaged they were in the decision-making process).

A total of 103 patients who ranged in age from 19 to 86 years (mean age: 50.4 years) were included in this study. Patients were taking an average of 8.4 medications daily, with the majority (7.5 medications) being prescription drugs. Over 80% of participants indicated that they would be willing to stop one of their medications if their clinician said that it was possible to do so, whereas 96% of participants reported communicating with their primary care clinician; only 20% reported interacting with their pharmacist.

Statistically significant factors associated with willingness to deprescribe a medication included older age (odds ratio [OR] 2.99 for every 10-year increase), having a college or graduate degree (OR = 55.25 vs. high school degree only), perceiving medications as being less appropriate (OR = 8.99), and perceiving that they effectively communicated with their clinician or pharmacist (OR = 4.56). Conversely, those who expressed a higher level of concern over discontinuing medications were also less open to deprescribing (OR = 0.08).

This article offers valuable insight for community pharmacists as most participants were willing to deprescribe a medication if a health professional deemed it appropriate. It also highlighted the need for more interaction between patients and pharmacists.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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