Patients' Attitudes Towards Deprescribing Differ Across Specific Cardiovascular and Diabetes Medication: A Survey Study Assessing Within‐Patient Differences

BACKGROUND: Knowing whether patients' attitudes towards deprescribing differ by medication is important for implementing deprescribing in practice. OBJECTIVE: To assess whether there are within-patient differences in attitudes towards deprescribing the following cardiovascular and diabetes medications: statins, antihypertensives, sulfonylureas and insulins. METHODS: We administered the revised Patient Attitudes Towards Deprescribing questionnaire to Dutch primary care patients. The 'appropriateness' and 'concerns' factors were adapted to measure medication-specific attitudes. Pairwise comparisons of appropriateness and concerns factor scores were tested with Wilcoxon signed-rank tests and corrected to control the false discovery rate. RESULTS: Responses from 160 patients (median age: 79 years, 34% frail) were used for the comparisons. Appropriateness factor scores were higher for insulins compared to statins (n = 18, 3.9 versus 3.3, p < 0.031), antihypertensives (n = 21, 4.0 versus 3.6, p < 0.031) and sulfonylureas (n = 12, 3.8 versus 3.4, p < 0.031) and higher for sulfonylureas compared to antihypertensives (n = 26, 3.6 versus 3.4, p = 0.036) and statins (n = 27, 3.6 versus 3.2, p = 0.006). No statistical differences were found for the concerns factor scores. CONCLUSION: Given the observed differences in appropriateness attitudes, patients may be more positive towards deprescribing statins and antihypertensives as compared to sulfonylureas and particularly insulins. Healthcare providers should be aware that patients can experience medication-specific barriers when discussing options for deprescribing.