Latent Class Analysis Identifies Four Distinct Patient Deprescribing Typologies Among Older Adults in Four Countries.

Abstract

Background and objectives: Polypharmacy, the concurrent use of multiple medicines, is a growing concern among older adults and those with chronic conditions. Deprescribing through dose reduction or discontinuing selected medicines is a strategy for reducing medicine-related harm. The Patient Deprescribing Typology was developed using qualitative methods to describe the varying factors that are important to older adults when they consider deprescribing. The objective of this study was to use quantitative methods to define distinct classes of older adults via the Patient Deprescribing Typology.

Research design and methods: This study used a cross-sectional experimental design in which data was collected via an online survey from participants 65 years and older in Australia, the Netherlands, the United Kingdom, and the United States. A latent class analysis was performed using the 4-item Patient Deprescribing Typology that collected data about the beliefs about the importance of medicines, how older adults learn about medicines, medicine decision-making preferences, and attitudes towards stopping medicines.

Results: Older adults (n = 2,250) were a median of 70 years and 2-thirds reported that their highest level of education was an associate's degree or trade school or less. We identified 4 distinct Patient Deprescribing Typology classes: Class 1 "Trusts their doctor" (41.6%), Class 2 "Makes own decisions" (30.2%), Class 3 "Avoids deprescribing" (15.5%), and Class 4 'Medicines not important' (12.7%).

Discussion and implications: Older adults report diverse perspectives about deprescribing, emphasizing the need for tailored communication strategies in clinical settings. Additional research is needed to examine older adults' preferences in real-world contexts to refine and improve deprescribing interventions.

Clinical trial registration: NCT04676282.