Older Adults' Awareness of Deprescribing: A Population-Based Survey

Abstract

Objectives: To determine older adults' awareness of the concept of medication-induced harm and their familiarity with the term "deprescribing." Secondary objectives were to ascertain determinants of self-initiated deprescribing conversations and to identify how older adults seek information on medication harms.

Design: Cross-sectional population-based household telephone survey using random-digit dialling.

Setting: Canada.

Participants: Community-dwelling adults aged 65 and older (N = 2,665; n = 898 men, n = 1,767 women, mean age 74.9 ± 7.2, range 65-100).

Measurements: Information was gathered on age; sex; awareness of the term "deprescribing"; knowledge and information-seeking behaviors related to medication harms; and previous initiation of a deprescribing conversation with a healthcare professional. Three targeted classes of potentially inappropriate prescriptions were asked about: sedative-hypnotics, glyburide, and proton pump inhibitors. Descriptive statistics and regression analyses were used to quantify associations.

Results: Two-thirds (65.2%, 95% confidence interval (CI) = 63.4-67.0%) of participants were familiar with the concept of medication-induced harms. Only 6.9% (95% CI = 5.9-7.8%) recognized the term deprescribing; 48% (95% CI = 46-50%) had researched medication-related harms. Older adults most commonly sought information from the Internet (35.5%, 95% CI = 33.4-37.6%), and from health care professionals (32.2%, 95% CI = 30.1-34.3%). Patient-initiated deprescribing conversations were associated with awareness of medication harms (odds ratio (OR) = 1.74, 95% CI = 1.46-2.07), familiarity with the term deprescribing (OR = 1.55, 95% CI = 1.13-2.12), and information-seeking behaviors (OR = 4.57, 95% CI = 3.84-5.45), independent of age and sex.

Conclusion: Healthcare providers can facilitate patient-initiated deprescribing conversations by providing information on medication harms and using the term "deprescribing."

Keywords: aged; deprescribing; potentially inappropriate medication; primary health care; questionnaire; survey.