Attitude towards medication deprescribing among older patients attending the geriatric centre: a cross-sectional survey in Southwest Nigeria

Abstract

OBJECTIVES: This study set out to assess older people's perception of their medications, attitude towards medication use and their willingness to have medications deprescribed in a geriatric centre in Southwestern Nigeria. DESIGN AND SETTING: A cross-sectional study was conducted at the Chief Tony Anenih Geriatric Centre, University of Ibadan, using an interviewer-administered questionnaire. The questionnaire used was a revised version of the Patient's Attitude Towards Deprescribing Questionnaire. Descriptive statistics, and multivariate and bivariate analyses were performed using SPSS V.23. Statistical significance was set at p<0.05. PARTICIPANTS: 415 older patients aged ≥60 years who attended the geriatric centre in University College Hospital Ibadan between April and July 2022. MAIN OUTCOME MEASURE: The primary outcome was the willingness of the older person to deprescribe if recommended by the physician. RESULTS: The mean age of the participants was 69.6±6.4 years, and 252 (60.7%) were female. Overall, the willingness and positive attitude to medication deprescribing among respondents were 60.5% and 89.7%, respectively. Factors significantly associated with willingness to deprescribe were financial self-support (p=0.021), having no previous hospital admission (p=0.009), better-perceived quality of health relative to peers (p<0.0001), polypharmacy (p=0.003), and the domains burden of medication (p=0.007), medication appropriateness (p<0.0001), concerns about stopping medications (p<0.0001) and involvement with medications (p<0.0001). The predictive factors for improved willingness to deprescribe were direct involvement with medications (OR=2.463; 95% CI 1.501 to 4.043, p<0.0001), medication appropriateness (OR=0.462; 95% CI 0.254 to 0.838, p=0.011) and concerns about stopping medications (OR=2.031; 95% CI 1.191 to 3.463, p=0.009). CONCLUSION: Participants demonstrated greater willingness to deprescribe if the physicians recommended it. Predictive factors that may influence willingness to deprescribe were direct involvement with medications, appropriateness of medication and concerns about stopping medications.