Key result
The prevalence of polypharmacy in two mid-Michigan counties was 44.0% and 42.5%, similar to the statewide average of 40.7%, with surveyed providers citing patient concerns and lack of time as major barriers to deprescribing.
Why the study?
Polypharmacy is common in the elderly, leading to increased morbidity and healthcare costs, yet prevalence and primary care provider perceptions of deprescribing remained undescribed in medically underserved mid-Michigan.
Cross-Sectional (n=27)
Yes
Despite a high prevalence of polypharmacy in mid-Michigan, primary care providers are generally supportive of deprescribing but face barriers such as patient concerns and limited visit time.
Answers are grounded in this paper and cite their sources.
High polypharmacy prevalence with PCP deprescribing confidence highlights actionable barriers; leaves open whether targeted interventions improve outcomes.
INTRODUCTION: Polypharmacy is common among the elderly and can predispose them to increased morbidity and higher healthcare expenditures. Deprescribing is an important aspect of preventative medicine to minimize polypharmacy-related adverse effects. Mid-Michigan has historically been considered a medically underserved area. We sought to describe polypharmacy prevalence and primary care provider (PCP) perceptions of deprescribing in the elderly at community practices in the region. METHODS: Medicare Part D claims data from 2018 to 2020 were queried to calculate the prevalence of polypharmacy, which is defined as Medicare beneficiaries who were concurrently prescribed at least five medications. PCPs from four community practices in adjacent counties in mid-Michigan, including two high- and two low-prescribing practices, were surveyed to assess their perceptions of deprescribing. RESULTS: The prevalence of polypharmacy in two adjacent mid-Michigan counties was 44.0% and 42.5%, which was similar to Michigan's overall prevalence of 40.7% (p = 0.720 and 0.844, respectively). Additionally, 27 survey responses were received from mid-Michigan PCPs (response rate, 30.7%). Most respondents expressed confidence in deprescribing in the elderly from a clinical standpoint (66.7%). Barriers to deprescribing included patient/family concerns (70.4%) and lack of time during office visits (37.0%). Facilitators to deprescribing included patient readiness (18.5%), collaboration with case managers/pharmacists (18.5%), and up-to-date medication lists (18.5%). An exploratory comparison of perceptions at high- and low-prescribing practices showed no significant differences. CONCLUSION: These findings demonstrate a high prevalence of polypharmacy in mid-Michigan and suggest that PCPs in the region are generally supportive of deprescribing. Potential targets to improve deprescribing in patients with polypharmacy include addressing visit length, patient/family concerns, increasing interdisciplinary collaboration, and medication reconciliation support.
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Zreik et al. (2023) conducted a cross-sectional in Polypharmacy in the elderly (n=27). Polypharmacy and deprescribing perceptions was evaluated on Prevalence of polypharmacy in two mid-Michigan counties compared to statewide prevalence (p=0.720). The prevalence of polypharmacy in two mid-Michigan counties was 44.0% and 42.5%, similar to the statewide average of 40.7%, with surveyed providers citing patient concerns and lack of time as major barriers to deprescribing.
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