Does polypharmacy education increase patient desire to reduce amount of prescription medications taken daily?

Purpose: Increased awareness of polypharmacy and its inherent risks in the medical community has made the management of medications in the elderly an important aspect of primary care.1,2 Although the benefits of deprescribing are well understood, providers still encounter barriers to deprescribing including patient hesitance or fear of discontinuing medications.2,3 This project was designed to increase patient understanding of polypharmacy and its inherent risks, and to determine whether increased understanding affected the patient's desire to reduce the amount of prescription medications taken daily. The project was designed with the hope that patients would be more aware of the medications they use and more amenable to deprescribing interventions in the future. Methods: Patients presenting to an outpatient family practice clinic were administered an optional survey that gathered information regarding their personal medication use. This survey included an educational component designed to inform patients of polypharmacy and its inherent risks. Participants responses were recorded, given numeric values according to their level of understanding, and excluded if a participant's response was indeterminable. Participants' understanding of polypharmacy and its associated risks, as well as their desire to reduce daily prescriptions, was analyzed before and after completing the included educational material using a paired sample t-test in Microsoft Excel. Results: 30 patients agreed to complete the survey over a span of three weeks, 86 % of which were 65 or older. Although 80 % of patients surveyed were experiencing polypharmacy by its traditional definition, over 85 % of patients surveyed had never heard of polypharmacy or had low understanding of the term. The statistics showed a significant increase in the understanding of the term polypharmacy as well as its associated risks in participants, but no significant increase in the number of participants who desired to decrease the amount of prescriptions they take daily. 70 % of patients indicated that they planned to bring a list of their medications to their next appointment. Conclusions: This study suggests that many patients, even those experiencing polypharmacy, are not aware of its risks. Although educating patients about polypharmacy and its associated risks did increase understanding, it did not significantly change patients' desires to reduce the amount of prescriptions taken daily. More than 50 percent of patients surveyed were already interested in reducing the amount of prescription medications they take daily prior to being educated about polypharmacy, possibly explaining the lack of significant change. Although overall understanding of polypharmacy did increase for this population, there were individuals who still rated their understanding as "low". Gathering participant feedback regarding the educational material may offer insight into what was and was not effective. Additionally, increasing the sample size and engaging a more diverse population may provide greater insight to patient understanding and desires.