Xi Liu,1,2 Yang Zhao,3,4 Tianya Da,1,2 Shilong Zhang,1,2 Haipeng Wang,1,2 Hui Li1,2 

1Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, People’s Republic of China; 3The George Institute for Global Health, University of New South Wales, Sydney, Australia; 4The George Institute for Global Health, Beijing, People’s Republic of China

Correspondence: Haipeng Wang; Hui Li, Email wanghaipeng@sdu.edu.cn; huili@sdu.edu.cn

Purpose: Multimorbidity and polypharmacy have emerged as significant global issues, heightening the risks of potentially inappropriate medications (PIMs). This necessitates medication optimization through deprescribing. Understanding patients’ decision-making preferences regarding medication cessation is crucial for mitigating medication-related risks. This study aims to capture the attitude of patients with multimorbidity towards deprescribing in rural China and to ascertain whether individual characteristics were linked to these attitudes.
Patient and Methods: A cross-sectional study employing the validated Patients’ Attitudes Towards Deprescribing (PATD) questionnaire was performed in rural regions of Eastern China. The PATD Questionnaire was utilized to investigate patients’ attitudes towards the concurrent use of multiple medications, with response elicited on a 5-point Likert scale. Utilizing multistage random sampling, a total of 560 participants with multimorbidity were randomly selected from two counties in Shandong Province. Descriptive statistics were reported on participant characteristics. Binary logistic regression analysis was conducted to identify the factors that influenced participants’ willingness to discontinue or reduce their medication.
Results: The median age of patients was 69.5 years (SD=8.2 years), and 314 were female. Nearly one in four patients experienced polypharmacy, while 42.2% had two chronic diseases. More than half of the participants (55.2%) reported that they would be willing to stop one or more medications if their physicians agreed, and 52.9% of participants agreed to reduce the medications taken. Participants with two chronic conditions (OR=3.038, 95% CI=1.342– 6.881), taking less than 10 tablets (OR=2.994, 95% CI=1.113– 8.054), having their own source of healthcare expenditure (OR=0.639, 95% CI=0.432– 0.945), and hospitalization in the prior year (OR=0.636, 95% CI=0.429– 0.944) were significantly associated with patients’ attitudes toward deprescribing.
Conclusion: Over half of patients with multimorbidity expressed a willingness to have one or more of their medicines deprescribed. Physicians can be trained in the integrated care of chronic diseases and encouraged to engage in discussions about deprescribing with patients having multimorbidity and polypharmacy during their routine practice.

Keywords: deprescribing, patient perspective, polypharmacy, potentially inappropriate medication