Exploring the Knowledge and Attitudes of Physicians on Polypharmacy and Deprescribing in Clinical Practice: a Cross-Sectional Study.

Objective: Polypharmacy, defined as the use of five or more medications, is increasingly prevalent among geriatric patients due to the complexity of managing multiple chronic conditions. This study aimed to evaluate physicians' knowledge of deprescribing, their familiarity with deprescribing tools and the factors influencing the deprescribing process. This cross-sectional survey was conducted among 290 physicians from four prominent tertiary care centers in South India between October 2023 and March 2024. A self-administered semi-structured questionnaire was employed to evaluate physicians' knowledge of polypharmacy, attitudes toward fall-risk-increasing drugs (FRIDs) and practices related to deprescribing interventions. Data collection was managed using Microsoft Excel, while descriptive and bivariate analyses were performed using SPSS to analyze the findings. The study revealed that a majority of physicians (148; 51.0%) were unfamiliar with the term "deprescribing" and reported no formal training in the practice. Analysis based on physicians' knowledge scores showed that participants with higher scores (≥28) demonstrated significantly greater awareness of the Tool to Improve Medications in the Elderly via Review (TIMER) and Fit fOR The Aged (FORTA) list compared to those with lower scores. Among these more knowledgeable physicians, 48.1% (n=13; p=0.054) were aware of TIMER but had not utilized it in practice, while 33.3% (n=9; p=0.016) reported familiarity with the FORTA list without its practical application. Deprescribing plays a vital role in managing polypharmacy and minimizing its associated risks in the aging population. However, its adoption is constrained by significant barriers, including a lack of awareness, insufficient formal training and limited integration of evidence-based deprescribing tools into clinical practice.