Latent Class Analysis Identifies Four Distinct Patient Deprescribing Typologies Among Older Adults in Four Countries
- PMID: 40008009
- PMCID: PMC11851471
- DOI: 10.1093/geroni/igaf002
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.
Keywords: Attitudes; Deprescription; Health care communication; Medicine; Patient preferences.
© The Author(s) 2025. Published by Oxford University Press on behalf of the Gerontological Society of America.
Conflict of interest statement
None.
Figures
Similar articles
-
The Patient Typology about deprescribing and medication-related decisions: A quantitative exploration.Basic Clin Pharmacol Toxicol. 2024 Jan;134(1):39-50. doi: 10.1111/bcpt.13911. Epub 2023 Jul 3. Basic Clin Pharmacol Toxicol. 2024. PMID: 37300477 Free PMC article.
-
Harm and Medication-Type Impact Agreement with Hypothetical Deprescribing Recommendations: a Vignette-Based Experiment with Older Adults Across Four Countries.J Gen Intern Med. 2023 May;38(6):1439-1448. doi: 10.1007/s11606-022-07850-5. Epub 2022 Nov 14. J Gen Intern Med. 2023. PMID: 36376636 Free PMC article. Clinical Trial.
-
Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis.Health Technol Assess. 2022 Jul;26(32):1-148. doi: 10.3310/AAFO2475. Health Technol Assess. 2022. PMID: 35894932 Free PMC article. Review.
-
Decision-Making Preferences and Deprescribing: Perspectives of Older Adults and Companions About Their Medicines.J Gerontol B Psychol Sci Soc Sci. 2018 Sep 20;73(7):e98-e107. doi: 10.1093/geronb/gbx138. J Gerontol B Psychol Sci Soc Sci. 2018. PMID: 29190369
-
An integrative systematic review of nurses' involvement in medication deprescription in long-term healthcare settings for older people.Ther Adv Drug Saf. 2024 Oct 16;15:20420986241289205. doi: 10.1177/20420986241289205. eCollection 2024. Ther Adv Drug Saf. 2024. PMID: 39429678 Free PMC article. Review.
Cited by
-
Authors' Reply: Enhancing the Clinical Relevance of Al Research for Medication Decision-Making.J Med Internet Res. 2025 Feb 18;27:e72007. doi: 10.2196/72007. J Med Internet Res. 2025. PMID: 39964740 Free PMC article. No abstract available.
References
-
- Ailabouni, N. J., Weir, K. R., Reeve, E., Turner, J. T., Norton, J. W., & Gray, S. L. (2022). Barriers and enablers of older adults initiating a deprescribing conversation. Patient Education and Counseling, 105(3), 615–624. https://doi.org/10.1016/j.pec.2021.06.021 - DOI - PubMed
-
- Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8 - DOI - PubMed
-
- Crutzen, S., Baas, G., Abou, J., van den Born-Bondt, T., Hugtenburg, J. G., Bouvy, M. L., Heringa, M., Taxis, K., & Denig, P. (2020). Barriers and enablers of older patients to deprescribing of cardiometabolic medication: A focus group study. Frontiers in Pharmacology, 11, 1268. https://doi.org/10.3389/fphar.2020.01268 - DOI - PMC - PubMed
-
- Degner, L. F., Sloan, J. A., & Venkatesh, P. (1997). The control preferences scale. Canadian Journal of Nursing Research Archive, 29, 21–43. https://doi.org/10.1037/t22188-000 - DOI - PubMed
-
- DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question: A meta-analysis. Journal of General Internal Medicine, 21, 267–275. https://doi.org/10.1111/j.1525-1497.2005.00291.x - DOI - PMC - PubMed
Associated data
LinkOut - more resources
Full Text Sources
Medical